Baker Joni F, Newman Sharlene D
Baker, PharmD, BCPP, Clinical Pharmacist Practitioner, Mental Health, Tuscaloosa Veterans Affairs Medical Center, Tuscaloosa, AL.
Newman, Ph.D, Executive Director, Alabama Life Research Institute, Professor, Psychology Department, University of Alabama, Adjunct Professor, Electrical and Computer Engineering, University of Alabama.
Psychopharmacol Bull. 2025 Feb 3;55(2):41-59.
Schizophrenia is a serious mental illness that is a leading cause of disability worldwide. While antipsychotic agents are the most effective medications, up to one-third of patients experience treatment resistance, and approximately one-sixth of patients experience ultra-resistant illness. There is a growing body of evidence that inflammation, oxidative stress, and neurodegeneration may be contributing to pathophysiology and treatment response. Several agents with potential to improve inflammation and oxidative stress have been investigated, with some showing statistically significant benefits, though robust improvement in symptomatology has not been consistently demonstrated. Hericium erinaceus (HE) is an edible mushroom that has been used as a medicinal food for centuries. In pre-clinical studies, it has demonstrated anti-inflammatory, antioxidant, neuroprotective, and neurogenesis-promoting effects. The specific inflammatory markers that are impacted by HE align well with biomarkers shown to be altered in chronic and treatment resistant schizophrenia. Most clinical studies to date have assessed HE for the treatment of mild cognitive impairment, depression, and anxiety. In clinical studies, HE has been well tolerated, with the most common adverse effect of gastrointestinal disturbance. Given potential for HE to improve inflammation, reduce oxidative stress, and promote adult neurogenesis in the hippocampus, it is theorized that HE may have beneficial effects on symptomatology when used as an add-on to antipsychotic therapy in those with residual symptoms or treatment resistance. The goal of this review is to describe theoretical benefits and potential dosing strategies based on pre-clinical and clinical data.
精神分裂症是一种严重的精神疾病，是全球致残的主要原因。虽然抗精神病药物是最有效的药物，但高达三分之一的患者存在治疗抵抗，约六分之一的患者患有极度难治性疾病。越来越多的证据表明，炎症、氧化应激和神经退行性变可能与病理生理学和治疗反应有关。已经研究了几种具有改善炎症和氧化应激潜力的药物，一些药物显示出统计学上的显著益处，尽管症状学上的显著改善尚未得到一致证实。猴头菇（HE）是一种可食用蘑菇，几个世纪以来一直被用作药用食品。在临床前研究中，它已显示出抗炎、抗氧化、神经保护和促进神经发生的作用。受HE影响的特定炎症标志物与在慢性和难治性精神分裂症中显示改变的生物标志物非常吻合。迄今为止，大多数临床研究评估了HE对轻度认知障碍、抑郁和焦虑的治疗效果。在临床研究中，HE耐受性良好，最常见的不良反应是胃肠道不适。鉴于HE有改善炎症、减轻氧化应激和促进海马体中成人神经发生的潜力，理论上认为，在有残留症状或治疗抵抗的患者中，将HE作为抗精神病治疗的附加药物使用时，可能对症状学有有益影响。本综述的目的是根据临床前和临床数据描述理论益处和潜在的给药策略。
