Efficacy and Safety of Sulforaphane Added to Antipsychotics for the Treatment of Negative Symptoms of Schizophrenia: A Randomized Controlled Trial.

IF 4.5 2区 医学 Q1 PSYCHIATRY
Jing Huang, AnMei Chen, Hua Jin, Fangkun Liu, Gangrui Hei, Ziwei Teng, Jingmei Xiao, Renrong Wu, Jingping Zhao, John M Davis, Ping Shao, Robert C Smith
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引用次数: 0

Abstract

Objective: There are few established treatments for negative symptoms in schizophrenia, which persist in many patients after positive symptoms are reduced. Oxidative stress, inflammation, and epigenetic modifications involving histone deacetylase (HDAC) have been implicated in the pathophysiology of schizophrenia. Sulforaphane has antioxidant properties and is an HDAC inhibitor. We conducted a 24-week, double-blind, placebo-controlled study, in Hunan, China, to assess the effect of high-dose sulforaphane (Nutramax extra strength sulforaphane tablets glucoraphanin content 30 mg/ tablet) on reducing negative symptoms in antipsychotic-treated patients with schizophrenia.

Methods: Participants were recruited from August 2020 to August 2022 and met DSM-5 criteria for schizophrenia. Participants were randomly assigned (2:1) to receive antipsychotics plus sulforaphane (1,700 mg Avmacol Extra Strength sulforaphane daily) or antipsychotics plus placebo for 24 weeks. Fifty-three patients treated with sulforaphane and 24 patients treated with placebo who had at least 1 postintervention clinical scale evaluation were analyzed. The primary outcome measure was change in the Positive and Negative Syndrome Scale (PANSS) negative symptoms.

Results: Sulforaphane-treated patients showed a significantly greater decrease in PANSS negative symptom total score (P = .01) and PANSS negative factor score (P = .02) than placebo-treated patients, with the most prominent difference occurring at 24 weeks (P ≤ .001) with a large effect size at this time point (d = 0.8). Sulforaphane's effect on decreasing negative symptoms was not mediated by changes in scores of depression or cognitive factors on the PANSS.

Conclusions: The results of this study suggest that add-on high-dose sulforaphane may reduce negative symptoms in patients with schizophrenia. The clinical significance of this reduction in negative symptoms needs further evaluation.

Trial Registration: ClinicalTrials.gov identifier: NCT04521868.

抗精神病药物中添加萝卜硫素治疗精神分裂症阴性症状的有效性和安全性:一项随机对照试验
目的:精神分裂症阴性症状的治疗方法很少,许多患者在阳性症状减轻后仍存在阴性症状。氧化应激、炎症和涉及组蛋白去乙酰化酶(HDAC)的表观遗传修饰与精神分裂症的病理生理有关。萝卜硫素具有抗氧化性能,是一种HDAC抑制剂。我们在中国湖南进行了一项为期24周的双盲安慰剂对照研究,以评估高剂量萝卜硫素(Nutramax特强型萝卜硫素片,萝卜硫素含量30mg /片)对减轻抗精神病治疗的精神分裂症患者阴性症状的影响。方法:参与者于2020年8月至2022年8月招募,符合DSM-5精神分裂症标准。参与者被随机分配(2:1)接受抗精神病药物加萝卜硫素(每天1700mg Avmacol特强型萝卜硫素)或抗精神病药物加安慰剂,持续24周。对53例萝卜硫素组患者和24例安慰剂组患者进行干预后至少1次临床量表评估。主要结局指标为阳性和阴性症状量表(PANSS)阴性症状的改变。结果:萝卜硫素组患者的PANSS阴性症状总分(P = 0.01)和PANSS阴性因子评分(P = 0.02)均显著低于安慰剂组,且差异在24周时最为显著(P≤0.001),且该时点效应量较大(d = 0.8)。萝卜硫素对减少阴性症状的作用不受PANSS中抑郁评分或认知因素变化的影响。结论:本研究结果提示,添加高剂量萝卜硫素可减轻精神分裂症患者的阴性症状。阴性症状减少的临床意义有待进一步评估。试验注册:ClinicalTrials.gov标识符:NCT04521868。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Clinical Psychiatry
Journal of Clinical Psychiatry 医学-精神病学
CiteScore
7.40
自引率
1.90%
发文量
0
审稿时长
3-8 weeks
期刊介绍: For over 75 years, The Journal of Clinical Psychiatry has been a leading source of peer-reviewed articles offering the latest information on mental health topics to psychiatrists and other medical professionals.The Journal of Clinical Psychiatry is the leading psychiatric resource for clinical information and covers disorders including depression, bipolar disorder, schizophrenia, anxiety, addiction, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder while exploring the newest advances in diagnosis and treatment.
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