Alpha-2 receptor antagonist add-on therapy in the treatment of schizophrenia; a meta-analysis

  title={Alpha-2 receptor antagonist add-on therapy in the treatment of schizophrenia; a meta-analysis},
  author={Eric M. Hecht and David C. Landy},
  journal={Schizophrenia Research},
Add-on clinical effects of selective antagonist of 5HT6 receptors AVN-211 (CD-008-0173) in patients with schizophrenia stabilized on antipsychotic treatment: pilot study
A randomized, double-blind, placebo-controlled, add-on, 4r-week trial in 47 schizophrenia patients found selective 5HT6 antagonist AVN-211 added antipsychotic and some procognitive (attention) effects to antipsychotics medication.
Pharmacological interventions in clozapine-refractory schizophrenia
Further research on memantine as clozapine augmentation strategy in patients suffering from treatment-resistant schizophrenia is justified.
Efficacy and Safety of Antidepressants Added to Antipsychotics for Schizophrenia: A Systematic Review and Meta-Analysis.
Analysis of primary outcomes (depressive and negative symptoms) suggests small, beneficial effects of adjunctive antidepressants suggests this augmentation can be accomplished with a low risk of exacerbation of psychosis and adverse effects.
Utility of Combined Treatment with Antipsychotic and Antidepressant Drugs: Scientific Rationales and Clinical Implications
The results propose that adjunct NET inhibition by reboxetine may be used to augment the antipsychotic effect of low doses of olanzapine in schizophrenia and improve the effect on negative symptoms and cognitive impairments.
Pharmacological treatment of negative symptoms in schizophrenia
  • H. Möller, P. Czobor
  • Psychology, Medicine
    European Archives of Psychiatry and Clinical Neuroscience
  • 2015
In general, the second-generation antipsychotics (SGAs) do not appear to have good efficacy in negative symptoms, although some show better efficacy than first-generation anti-schizophrenia drugs, some of which also demonstrated efficacy innegative symptoms.
Antidepressants for cognitive impairment in schizophrenia — A systematic review and meta-analysis
One-day tropisetron treatment improves cognitive deficits and P50 inhibition deficits in schizophrenia
One day of treatment with tropisetron improved both cognitive and P50 inhibition deficits, suggesting that longer term treatment with α7 nAChR agonists for these deficits in SCZ may be promising.
Selective noradrenaline reuptake inhibitors for schizophrenia.
The main outcomes of interest were significant response or improvement in positive/negative mental state, global state and cognitive functioning, average cognitive functioning scores, significant response and improvement in quality of life and incidence of nausea.
Adjunctive use of nonsteroidal anti-inflammatory drugs for schizophrenia: a meta-analytic investigation of randomized controlled trials.
Results indicate that adjunctive NSAIDs for schizophrenia may not benefit patients treated with first-line antipsychotics judged by PANSS total score change, and further controlled studies are needed, especially in first-episode patients.
Emerging drugs for schizophrenia: an update
Although modifications and variations of antidopaminergic mechanisms are expected to be successful, the added benefits will likely remain small, at least regarding enhanced efficacy for negative symptoms, cognition and functional outcomes.


Efficacy of mirtazapine add on therapy to haloperidol in the treatment of the negative symptoms of schizophrenia: a double-blind randomized placebo-controlled study
A potential role for mirtazapine in the negative symptoms of schizophrenia is suggested, and there was no difference between the groups on the Hamilton depression scale at endpoint, suggesting that the improvement in negative symptoms was not an artifact of mood improvement.
Effects of add-on mirtazapine on neurocognition in schizophrenia: a double-blind, randomized, placebo-controlled study.
Adjunctive mirtazapine might offer a safe, effective and cost-saving option as a neurocognitive enhancer for FGA-treated schizophrenia patients and may become especially useful in light of the currently increasing attention towards FGAs.
The effect of mirtazapine augmentation of clozapine in the treatment of negative symptoms of schizophrenia: a double-blind, placebo-controlled study
Findings suggest a potential role for mirtazapine as an augmentation strategy in the treatment of negative symptoms of schizophrenia.
Efficacy of antidepressants in treating the negative symptoms of chronic schizophrenia: meta-analysis.
Antidepressants along with antipsychotic drugs are more effective in treating the negative symptoms of schizophrenia than antipsychotics alone.
Mianserin or placebo as adjuncts to typical antipsychotics in resistant schizophrenia
This study indicates that patients with chronic treatment-resistant schizophrenia who have an acute psychotic exacerbation (‘acute-on-chronic’) may benefit from the addition of a potent 5-HT2 blocker, such as mianserin, to typical antipsychotics.
Combined alpha2 and D2/3 receptor blockade enhances cortical glutamatergic transmission and reverses cognitive impairment in the rat.
The combination of idazoxan and raclopride completely reversed the working-memory impairment in rats induced by MK-801, and define presynaptic alpha(2) adrenoceptors as major targets in antipsychotic drug development.
Polypharmacy in schizophrenia
This review summarizes the current state of evidence of combined antipsychotic treatment strategies and the augmentation of antipsychotics with mood stabilizers, antidepressants and experimental substances and concludes that rigorous data on combination therapy in schizophrenia are rare and further randomized controlled trials, naturalistic trials and head-to-head-trials are necessary.