Emerging drugs for schizophrenia: an update

@article{Kster2014EmergingDF,
  title={Emerging drugs for schizophrenia: an update},
  author={Luisa-Sophie K{\"o}ster and Maren Carbon and Christoph U. Correll},
  journal={Expert Opinion on Emerging Drugs},
  year={2014},
  volume={19},
  pages={511 - 531}
}
Introduction: Schizophrenia is one of the most serious mental disorders. Its treatment remains challenging, as existing antipsychotic antidopaminergic medications improve only/predominantly positive symptoms, agitation and aggression but have limited/insignificant efficacy for negative and cognitive symptoms, which strongly affect functional outcome. Therefore, new therapeutic agents are urgently needed that treat aspects of the spectrum of schizophrenia symptomatology and improve functional… 
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References

SHOWING 1-10 OF 145 REFERENCES
Alternative pharmacologic targets for the treatment of schizophrenia: results from phase I and II trials
TLDR
Experimental therapeutic research for schizophrenia is rapidly expanding and a number of compounds with novel mechanisms of action are demonstrating encouraging evidence for efficacy across a range of symptoms, however, much work still needs to be conducted before these new agents can be considered for routine clinical treatment.
Emerging approaches for treatment of schizophrenia: modulation of glutamatergic signaling.
TLDR
It is possible that agents that target glutamatergic signaling in the CNS could have efficacy in reducing all major symptom clusters, providing a more comprehensive treatment strategy, and also avoiding some of the adverse effects that are seen with currently available treatments.
Pharmacological treatment of schizophrenia: a critical review of the pharmacology and clinical effects of current and future therapeutic agents
TLDR
An update and critical review of the pharmacology and clinical profiles of current antipsychotic drugs and drugs acting on novel targets with potential to be therapeutic agents in the future is provided.
Emerging approaches for treatment of schizophrenia: modulation of cholinergic signaling.
TLDR
Evidence suggests that molecules that modulate signaling by the neurotransmitter acetylcholine (ACh) could provide a more comprehensive treatment of schizophrenia than currently prescribed antipsychotics and further research is needed to examine the utility of such compounds as therapeutics.
Addressing the unmet needs of patients with persistent negative symptoms of schizophrenia: emerging pharmacological treatment options
TLDR
The lack of clearly efficacious pharmacological treatments for the management of negative symptoms represents a significant unmet need, especially considering the importance of these symptoms on patient outcomes, and further research to identify and characterize novel pharmacology treatments is greatly needed.
Efficacy of anti-inflammatory agents to improve symptoms in patients with schizophrenia: an update.
TLDR
The results of aspirin addition to antipsychotic treatment seem promising, as does the addition of NAC and estrogens, and it has to be investigated if the beneficial effects on symptom severity are indeed mediated by their anti-inflammatory aspects.
Past and present progress in the pharmacologic treatment of schizophrenia.
TLDR
A historical overview of the pharmacologic advances in the treatment of schizophrenia over the past 50 years is presented, followed by a review of the current developments in optimizing the treatment and outcomes in patients with schizophrenia.
What are we looking for in new antipsychotics?
  • C. Correll
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 2011
TLDR
It is hoped that research on drug-specific biomarkers that can predict response in specific patient groups will advance personalized psychiatric care and improve patient outcomes.
[Treatment of cognitive deficits in schizophrenia. Part 2: Pharmacological strategies].
TLDR
A detailed review of the literature on strategies for the pharmacological treatment of cognitive deficits in schizophrenia is presented, finding the add-on use of substances which directly influence cognitive processes, so-called cognition-enhancing drugs is more promising.
Antidepressants for the negative symptoms of schizophrenia.
TLDR
The combination of antipsychotic and antidepressant combinations with antipsychotics alone and antidepressants may be effective in treating negative symptoms of schizophrenia, but the amount of information is currently too limited to allow any firm conclusions.
...
...