Do Histamine receptor 3 antagonists have a place in the therapy for schizophrenia?

In spite of almost 60 years of experience with the pharmacological treatment of schizophrenia, there is still a large unmet medical need for better control of especially the negative and cognitive symptoms of schizophrenia. One potential new avenue is the selective blockade of histamine H3 receptors (H3R). Based on a large basis of preclinical data, H3R antagonists or inverse agonists have been suggested to improve cognition in a variety of neurological and psychiatric indications. The aim of the present paper is to review the potential usefulness of H3R antagonists for the treatment of schizophrenia. Although, so far no H3R antagonist has been marketed and many phase II and III studies are still underway, the available data seem to indicate that H3R antagonists may not be primarily effective against the positive symptoms (i.e. the psychotic symptoms such as hallucinations and delusions) but may hold a promise as add-on therapy for selectively improving cognitive and perhaps negative symptoms.