Capuzzi Enrico, Caldiroli Alice, Quitadamo Cecilia, Butturini Francesco, Surace Teresa, Clerici Massimo, Buoli Massimiliano
Fondazione IRCCS, Department of Mental Health and Addiction, San Gerardo Dei Tintori, Monza, Italy.
Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy.
Expert Opin Pharmacother. 2023 Sep-Dec;24(14):1623-1648. doi: 10.1080/14656566.2023.2231346. Epub 2023 Jul 10.
The severity of positive symptoms in schizophrenia is associated with poor prognosis. About one-third of schizophrenia patients partially respond to treatment with available antipsychotics. The purpose of the present manuscript is to provide an updated overview of novel pharmacotherapy targeting positive symptoms in schizophrenia.
A comprehensive research on the main database sources (PubMed, PsychINFO, Isi Web of Knowledge, MEDLINE, and EMBASE) was performed to obtain original articles published till 31 January 2023 about new pharmacological strategies for the treatment of positive symptoms in schizophrenia.
The most promising compounds include: lamotrigine, pro-cognitive-compounds (donepezil - in the short term, idazoxan and piracetam) and drugs acting partially or totally outside the Central Nervous System (CNS) (anti-inflammatory drugs: celecoxib, methotrexate; cardiovascular compounds: L-theanine, mononitrate isosorbide, propentofylline, sodium nitroprusside; metabolic regulators: diazoxide, allopurinol; others: bexarotene, raloxifene [in women]). The effectiveness of the latter compounds indicates that other biological systems, such as immunity or metabolism can be object of future research to identify pharmacological targets for positive symptoms of schizophrenia. Mirtazapine could be useful for treating negative symptoms without increasing the risk of a worsening of delusions/hallucinations. Nevertheless, the lack of replication of studies prevents to draw definitive conclusions and future studies are needed to confirm the findings presented in this overview.
精神分裂症阳性症状的严重程度与预后不良相关。约三分之一的精神分裂症患者对现有抗精神病药物治疗仅部分有反应。本手稿的目的是提供针对精神分裂症阳性症状的新型药物治疗的最新综述。
对主要数据库来源（PubMed、PsychINFO、Isi Web of Knowledge、MEDLINE和EMBASE）进行了全面研究，以获取截至2023年1月31日发表的关于治疗精神分裂症阳性症状的新药理学策略的原创文章。
最有前景的化合物包括：拉莫三嗪、促认知化合物（短期使用的多奈哌齐、伊达唑烷和吡拉西坦）以及部分或完全作用于中枢神经系统（CNS）之外的药物（抗炎药：塞来昔布、甲氨蝶呤；心血管化合物：L-茶氨酸、单硝酸异山梨酯、丙戊茶碱、硝普钠；代谢调节剂：二氮嗪、别嘌醇；其他：贝沙罗汀、雷洛昔芬[女性适用]）。后一类化合物的有效性表明，其他生物系统，如免疫或代谢，可能成为未来研究的对象，以确定精神分裂症阳性症状的药理学靶点。米氮平可能有助于治疗阴性症状，而不会增加妄想/幻觉恶化的风险。然而，研究缺乏重复性，无法得出明确结论，需要未来的研究来证实本综述中提出的发现。
