Aspirin

• No update available

Celecoxib

• A group in India conducted a study of two groups of schizophrenic patients, treated open-label with either olanzapine or olanzapine with celecoxib for six weeks. The add-on celecoxib with olanzapine was superior to olanzapine alone in improving the psychopathology in patients.
• Although not performed on patients with schizophrenia or bipolar disorder, a study by Dr. Sayyah from the Univeristy of Jundishapur in Iran reported that celecoxib, given together with fluoxetine, improved symptoms in patients with obsessive-compulsive disorder. http://www.ncbi.nlm.nih.gov/pubmed?term=Sayyah%20celecoxib

Estrogen/Raloxifene

• In a randomized controlled trial in Iran, 16 women of childbearing age with chronic schizophrenia were given 0.625 mg/day estrogen in combination with antipsychotic treatment. These women showed significant improvement in psychopathology as compared to 16 women who received placebo and antipsychotics. http://www.ncbi.nlm.nih.gov/pubmed/?term=Ghafari+estrogen
•  A randomized, placebo-controlled trial in Spain tested the effects of raloxifene on cognition in postmenopausal women with schizophrenia. Thirty-three patients were randomized to receive either adjuvant raloxifene or placebo for three months in addition to usual antipsychotic medication. Some significant improvements were observed in verbal memory and some executive functions. http://www.ncbi.nlm.nih.gov/pubmed/24342775

Folate

• 112 young adults (ages 14-24) whose father and/or mother had BP or recurrent depression were randomized to folic acid 2.5 mg. or placebo for 3 years to try and prevent the onset of mood disorders in the young adults. Those continuing in the study at 12, 24 and 36 months were 87, 60, and 27. There was no difference in the development of mood disorders between those on folic acid (14%) and placebo (18%).
• Joshua Roffman, et al from Massachusetts General Hospital, administered 2 mg of folic acid and 400 mg of vitamin B12 or placebo, in addition to antipsychotic medication to 140 outpatients with chronic schizophrenia. After a period of 16 weeks, improvement of negative symptoms of schizophrenia was detected, but was influenced by individuals’ genetic variation in folate absorption. No differences in positive and total symptoms were detected between the treatment groups. This is an encouraging step towards an individualized medicine approach in schizophrenia. http://www.ncbi.nlm.nih.gov/pubmed/23467813

Minocycline

• Gopal Vyas’s group at the Maryland Psychiatric Research Center reported on a 30 year old Caucasian male with catatonic schizophrenia , who experienced severe auditory hallucinations and paranoid delusions. After the patient’s successful completion of an ongoing randomized controlled trial of minocycline as an adjunct to clozapine, he then elected to take add-on minocycline with clozapine in an inpatient setting. Within one to three days of beginning the minocycline, he experienced profound improvement with auditory hallucinations and other clinical symptoms, enabling the patient to prepare for discharge. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044641/
• Ninety-two patients with early stage schizophrenia being treated with risperidone, were randomized to receive either minocycline or placebo. Patients receiving minocycline in addition to risperidone showed improved negative symptoms, as measured by SANS, PANSS and CGI-S scores. No significant differences were observed in positive symptoms. http://www.ncbi.nlm.nih.gov/pubmed/24503176
• In a randomized, placebo-controlled trial in Iran, 40 patients with chronic schizophrenia being treated with risperidone for a minimum of eight weeks, and with an average disease duration of 20 years, were assigned to receive add-on minocycline or placebo. The group receiving minocycline showed significantly greater improvement in negative symptoms and general psychopathology than the placebo group. http://www.ncbi.nlm.nih.gov/pubmed/24480077

Mirtazapine

• No update available

Omega-3 Fatty Acids (fish oil)

• A group in Norway conducted a placebo-controlled trial of omega-3 fatty acid and vitamins E and C for treating schizophrenia. In a 2×2 factorial design, 97 patients were randomized to receive active or placebo omega-3, and active or placebo vitamin E and C for 16 weeks. Levels of polyunsaturated fatty acids (PUFAs) were measured in the patients to investigate this as a predictor of response. Given separately, EPA and vitamins increased drop-out rates, whereas when combined, they did not differ from placebo. In low PUFA patients, adding vitamins to EPA improved psychotic symptoms, but was not beneficial when given separately, as measured by PANSS. In high PUFA patients, there were no significant effects of trial drugs. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3906471/

Pramipexole

• A paper by Dr. Burdick from the Mt. Sinai School reported that overall, Pramipexole did not improve cognition in patients with bipolar disorder. However, the effect of the drug on cognition was influenced by the presence or absence of mood symptoms, and additional analyses focusing on those patients who were neither depressed nor manic showed that they did experience some improvement in their cognitive abilities. http://www.ncbi.nlm.nih.gov/pubmed/22152405
• A pilot, randomized, controlled-trial of pramipexole (increasing amounts up to 4.50 mg/day) was conducted in 24 patients with schizophrenia or schizoaffective disorder. The drug or placebo was added to their antipsychotic regimen for 12 weeks, and showed some improvement in symptoms. Effects on negative symptoms, cognition and mood were negligible. http://www.ncbi.nlm.nih.gov/pubmed/22153972

Pregnenolone

• Chris Marx from Duke University conducted a randomized controlled trial of 120 patients, randomized to increasing amounts of pregnenolone or placebo for 8 weeks, to assess changes in functional capacity, cognitive symptoms and negative symptoms. Participants who received at least one dose of study drug demonstrated greater improvements in overall functioning compared to the placebo group.
• Sixty patients with schizophrenia or schizoaffective disorder, with poor response to antipsychotics, were randomized to receive either add-on pregnenolone or placebo. Significant improvement was observed in weeks 6 and 8 of treatment among patients who were not treated with concomitant mood stabilizers. Pregnenolone significantly reduced some negative symptoms as measured by PANSS. http://www-ncbi-nlm-nih-gov.lrc1.usuhs.edu/pubmed/24548129