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Antioxidant treatments for schizophrenia
Pedro V S Magalhães1, Olivia Dean, Ana C Andreazza
1Department of Psychiatry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil, 90035-903.
The Cochrane Database of Systematic Reviews
|February 6, 2016
Summary
Antioxidants show potential in reducing psychotic symptoms in schizophrenia when used with antipsychotics, but more research is needed. Current evidence is limited, highlighting the need for larger trials with longer follow-up periods.
Area of Science:
- Neuroscience and Psychiatry
- Pharmacology and Therapeutics
Background:
- Schizophrenia involves progressive brain changes, with oxidative stress implicated in neuroprogression and cognitive decline.
- Antioxidants combat oxidative stress, and while current antipsychotics affect oxidative pathways, they may not fully restore antioxidant balance.
- Interest exists in antioxidant interventions to complement antipsychotics for schizophrenia treatment.
Purpose of the Study:
- To assess the efficacy of antioxidants as adjunctive therapy to standard antipsychotics in schizophrenia.
- To evaluate improvements in acute psychotic episodes, core symptoms, and relapse prevention.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) involving schizophrenia patients receiving antioxidants plus antipsychotics versus placebo plus antipsychotics.
- Searched multiple databases up to January 2015, including Cochrane Schizophrenia Group's Study-Based Register of Trials.
- Data extraction and analysis included risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI), assessing risk of bias and using GRADE methodology.
Main Results:
- 22 RCTs evaluated various antioxidants (e.g., Ginkgo biloba, N-acetyl cysteine, vitamin C/E) with a median follow-up of eight weeks.
- Adjunctive antioxidants showed a potential reduction in psychotic symptoms based on PANSS and BPRS scores (low to very low quality evidence).
- No significant differences were found in clinical response, study withdrawal, general functioning, or serious adverse events; data on relapse and quality of life were unavailable.
Conclusions:
- The current evidence on antioxidants for schizophrenia is limited by small sample sizes, short follow-up periods, and inadequate power in most trials.
- While some trials showed low risk of attrition and reporting bias, they lacked sufficient duration and meaningful outcome measures.
- Larger, longer-term RCTs are needed to evaluate meaningful outcomes, including functioning, quality of life, relapse rates, and safety.
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