Novel pharmaceutical treatment approaches for schizophrenia: a systematic literature review.

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2025-04-01 Epub Date: 2025-02-14 DOI:10.1007/s00228-025-03809-7

Anan Jarab, Walid Al-Qerem, Adam Khdour, Heba Awadallah, Yousef Mimi, Maher Khdour

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引用次数: 0

Abstract

Purpose: Schizophrenia is a chronic and debilitating neuropsychiatric disorder affecting approximately 1% of the global population. Traditional antipsychotic treatments, while effective for positive symptoms, often have significant side effects and fail to address cognitive and negative symptoms. Novel pharmacological treatments targeting muscarinic receptors, TAAR1 agonists, serotonergic pathways, and glutamate modulation have emerged as promising alternatives.

Aim: This systematic literature review aims to critically evaluate the efficacy, safety, and mechanisms of action of novel pharmacological agents in the treatment of schizophrenia.

Methods: A comprehensive search was conducted across PubMed, Embase, Cochrane Library, Scopus, and Web of Science for randomized controlled trials (RCTs) and clinical trials published between April 2014 and March 2024. Studies evaluating novel treatments targeting muscarinic receptors, TAAR1 agonists, serotonergic agents, and glutamate modulation were included. Primary outcomes focused on symptom reduction and quality of life, while secondary outcomes included cognitive function and adverse events. The Joanna Briggs Institute (JBI) tool was used for quality assessment.

Results: Eleven studies involving 4614 participants (mean age 37-43 years, predominantly male) were included. Drugs evaluated included xanomeline-trospium (KarXT), pimavanserin, ulotaront, emraclidine, and bitopertin. Significant improvements in PANSS and CGI-S scores were observed, with xanomeline-trospium showing a mean reduction of 17.4 points (p < 0.001). Adverse events were mostly mild and transient, with nausea, constipation, and somnolence being common.

Conclusion: Novel treatments for schizophrenia show promise in managing both positive and negative symptoms, with generally favorable safety profiles. Future studies should focus on large-scale, long-term trials to refine their efficacy, safety, and clinical applicability.

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精神分裂症的新型药物治疗方法：系统的文献综述。

目的：精神分裂症是一种慢性衰弱性神经精神疾病，影响全球约1%的人口。传统的抗精神病药物虽然对阳性症状有效，但往往有明显的副作用，无法解决认知和阴性症状。针对毒蕈碱受体、TAAR1激动剂、血清素能途径和谷氨酸调节的新药物治疗已成为有希望的替代方案。目的：本系统的文献综述旨在批判性地评估新型药物治疗精神分裂症的有效性、安全性和作用机制。方法：综合检索PubMed、Embase、Cochrane Library、Scopus和Web of Science，检索2014年4月至2024年3月间发表的随机对照试验（rct）和临床试验。研究评估了针对毒蕈碱受体、TAAR1激动剂、血清素能剂和谷氨酸调节的新治疗方法。主要结局关注症状减轻和生活质量，而次要结局包括认知功能和不良事件。乔安娜布里格斯研究所（JBI）工具用于质量评估。结果：纳入了11项研究，涉及4614名参与者（平均年龄37-43岁，主要为男性）。评估的药物包括xanomeline-trospium （KarXT）、pimavanserin、ulotaront、emraclidine和bitopertin。观察到PANSS和CGI-S评分显著改善，xanomeline-trospium平均降低17.4分（p < 0.001）。不良事件大多是轻微和短暂的，恶心、便秘和嗜睡是常见的。结论：精神分裂症的新治疗方法在治疗阳性和阴性症状方面都有希望，并且通常具有良好的安全性。未来的研究应侧重于大规模、长期的试验，以完善其疗效、安全性和临床适用性。

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

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.