Pharmacotherapy of Schizophrenia: Ploypharmacy Approaches
Abstract
Schizophrenia is a debilitating illness, rating as one of the leading causes of lost years of quality of life. The illness imposes a disproportionate burden on patients and their families, healthcare systems and society. Pharmacological management is the cornerstone of treatment of schizophrenia, and antipsychotics, both first generation of antipsychotics and second generation of antipsychotics, are efficacious in reducing levels of psychopathology in acute episodes of schizophrenia. Clearly a need for innovative treatment strategies in schizophrenia that will ensure increased effectiveness against negative symptoms and cognitive dysfunction dysfunction. Therefore, in majority of cases polypharmacy is one of the effective approaches. This review focused on polypharmacy in the treatment of schizophrenia and in particular negative symptoms.
Andreasen NC. Schizophrenia: the fundamental questions. Brain Res Brain Res Rev 2000;31(2-3):106-12.
Akhondzadeh S, Malek-Hosseini M, Ghoreishi A, Raznahan M, Rezazadeh SA. Effect of ritanserin, a 5HT2A/2C antagonist, on negative symptoms of schizophrenia: a double-blind randomized placebo-controlled study. Prog Neuropsychopharmacol Biol Psychiatry 2008;32(8):1879-83.
Akhondzadeh S. The 5-HT hypothesis of schizophrenia. IDrugs 2001;4(3):295-300.
Akhondzadeh S. Pharmacotherapy of schizophrenia: the past, present and future. Curr Drug Ther 2006;1(1):1-7.
Mohammadi MR, Akhondzadeh S. Schizophrenia: etiology and pharmacotherapy. IDrugs 2001;4(10):1167-72.
Nieratschker V, Nöthen MM, Rietschel M. New Genetic Findings in Schizophrenia: Is there Still Room for the Dopamine Hypothesis of Schizophrenia? Front Behav Neurosci 2010;4:23.
Heinz A, Schlagenhauf F. Dopaminergic dysfunction in schizophrenia: salience attribution revisited. Schizophr Bull 2010;36(3):472-85.
Jablensky A, Sartorius N, Ernberg G. Schizophrenia: manifestation, incidence and course in different cultures. A World Health Organization ten-country study. Psychological Med Mono Supplement 1992;20(suppl):1-97.
Nestler EJ. Schizophrenia. An emerging pathophysiology. Nature 1997;385(6617):578-9.
Wright I, Woodruff P. Aetiology of schizophrenia Review of theories and their clinical and therapeutic implications. CNS Drugs 1995;3:126-44.
Heyman I, Murray RM. Schizophrenia and neurodevelopment. J R Coll Physicians Lond 1992;26(2):143-6.
Littrell RA, Schneiderhan M. The neurobiology of schizophrenia. Pharmacotherapy 1996;16(6 Pt 2):143S-147S; discussion 166S-168S.
Snyder SH. The dopamine hypothesis of schiAzophrenia: focus on the dopamine receptor. Am J Psychiatry 1976;133(2):197-202.
Johnstone EC, Crow TJ, Frith CD, Carney MW, Price JS. Mechanism of the antipsychotic effect in the treatment of acute schizophrenia. Lancet 1978;1(8069):848-51.
Carlsson A. The current status of the dopamine hypothesis of schizophrenia. Neuropsychopharmacology 1988;1(3):179-86.
Kendler KS, Diehl SR. The genetics of schizophrenia: a current, genetic-epidemiologic perspective. Schizophr Bull 1993;19(2):261-85.
Meltzer HY, Lee MA, Ranjan R. Recent advances in the pharmacotherapy of schizophrenia. Acta Psychiatr Scand Suppl 1994;384:95-101.
Arndt S, Allinger RJ, Anderson NC. The distinction of positive and negative symptoms. The failure of a two dimensional model. Br J Psychiatry 1991;158:317-22.
Akhondzadeh S, Mohammadi MR, Amini-Nooshabadi H, Davari-Ashtiani R. Cyproheptadine in treatment of chronic schizophrenia: a double-blind, placebo-controlled study. J Clin Pharm Ther. 1999;24(1):49-52.
Akhondzadeh S, Malek-Hosseini M, Ghoreishi A, Raznahan M, Rezazadeh SA. Effect of ritanserin, a 5HT2A/2C antagonist, on negative symptoms of schizophrenia: a doubleblind randomized placebo-controlled study. Prog Neuropsychopharmacol Biol Psychiatry 2008;32(8):1879-83.
Akhondzadeh S, Mohammadi N, Noroozian M, Karamghadiri ACnia. J Clin Pharm Ther 1998;23(4):243-6.
Noorbala AA, Akhondzadeh S, Davari-Ashtiani R, Amini- Nooshabadi H. Piracetam in the treatment of schizophrenia: implications for the glutamate hypothesis of schizophrenia. J Clin Pharm Ther 1999;24(5):369-74.
Goff DC, Freudenreich O, Evins AE. Augmentation strategies in the treatment of schizophrenia. CNS Spectr 2001;6(11):904, 907-11.
Goff DC, Herz L, Posever T, Shih V, Tsai G, Henderson DC, et al. A six-month, placebo-controlled trial of D-cycloserine co-administered with conventional antipsychotics in schizophrenia patients. Psychopharmacology (Berl) 2005;179(1):144-50.
Goff DC, Cather C, Gottlieb JD, Evins AE, Walsh J, Raeke L, et al. Once-weekly D-cycloserine effects on negative symptoms and cognition in schizophrenia: an exploratory study. Schizophr Res 2008;106(2-3):320-7.
Akhondzadeh S, Shasavand E, Jamilian H, Shabestari O, Kamalipour A. Dipyridamole in the treatment of schizophrenia: adenosine-dopamine receptor interactions. J Clin Pharm Ther 2000;25(2):131-7.
Akhondzadeh S, Safarcherati A, Amini H. Beneficial antipsychotic effects of allopurinol as adjunctive therapy for schizophrenia: A double blind, randomized and placebo controlled trial. Prog Neuropsychopharmacol Biol Psych 2005;29(2):253-9.
Brunstein MG, Ghisolfi ES, Ramos FL, Lara DR. A clinical trial of adjuvant allopurinol therapy for moderately refractory schizophrenia. J Clin Psychiatry 2005;66(2):213-9.
Salimi S, Fotouhi A, Ghoreishi A, Derakhshan MK, Khodaie- Ardakani MR, Mohammadi MR, et al. A placebo controlled study of the propentofylline added to risperidone in chronic schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2008;32(3):726-32.
Erhart SM, Marder SR, Carpenter WT. Treatment of schizophrenia negative symptoms: future prospects. Schizophr Bull 2006;32(2):234-7.
Buckley PF, Stahl SM. Pharmacological treatment of negative symptoms of schizophrenia: therapeutic opportunity or cul-desac? Acta Psychiatr Scand 2007;115(2):93-100.
Agid O, Kapur S, Remington G. Emerging drugs for schizophrenia. Expert Opin Emerg Drugs 2008;13(3):479-5.
Amiri A, Noorbala AA, Nejatisafa AA, Ghoreishi A, Derakhshan MK, Khodaie-Ardakani MR, Hajiazim M, Raznahan M, Akhondzadeh S. Efficacy of selegiline add on therapy to risperidone in the treatment of the negative symptoms of schizophrenia: a double-blind randomized= placebo-controlled study. Hum Psychopharmacol 2008;23(2):79-86.
Abbasi SH, Behpournia H, Ghoreshi A, Salehi B, Raznahan M, Rezazadeh SA, et al. The effect of mirtazapine add on therapy to risperidone in the treatment of schizophrenia: a double-blind randomized placebo-controlled trial. SchizophrRes 2010;116(2-3):101-6.
Akhondzadeh S, Rezaei F, Larijani B, Nejatisafa AA, Kashani L, Abbasi SH. Correlation between testosterone, gonadotropins and prolactin and severity of negative symptoms in male patients with chronic schizophrenia. Schizophr Res 2006;84(2-3):405-10.
Akhondzadeh S, Tabatabaee M, Amini H, Ahmadi Abhari SA, Abbasi SH, Behnam B. Celecoxib as adjunctive therapy in schizophrenia: a double-blind, randomized and placebocontrolled trial. Schizophr Res 2007;90(1-3):179-85.
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Issue | Vol 48, No 4 (2010) | |
Section | Original Article(s) | |
Keywords | ||
Glutamates serotonin polypharmacy schizophrenia |
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