title: The effect of artemether on psychotic symptoms and cognitive impairment in first-episode, antipsychotic drug-naive persons with schizophrenia seropositive to Toxoplasma gondii.
abstract: The objective was to evaluate the efficacy and safety of add-on artemether in first-episode, untreated people with schizophrenia, who were Toxoplasma gondii seropositive, and explore the change in T. gondii antibodies during treatment. In this eight-week, double-blind, randomized, placebo-controlled trial, 100 T. gondii seropositive participants with schizophrenia were randomized to either the artemether or placebo group. Participants in the artemether group received 80 mg artemether once per day during the second week (days 8-14) and the fourth week (days 22-28). Participants in the placebo group received identical looking placebo capsules. Psychopathology, adverse side effects and cognitive function were measured using standardized instruments. The group × time interaction effects for the scores of the Positive and Negative Syndrome Scale (PANSS) subscales and performances on all cognitive components were not significant, only the main effect of group was significant. Compared to the placebo group, artemether group participants showed significantly greater reduction in the PANSS negative symptom scale (F(1,46) = 4.7, p = 0.03) and the Clinical Global Impressions Scale (F(1,96) = 6.2, p = 0.01) scores, but there were no significant differences in the PANSS positive symptom and general psychopathology scales (p > 0.05). There were also no significant differences between the two groups in performance on any of the Brief Assessment of Cognition in Schizophrenia (BACS) cognitive domains. The artemether-risperidone combination is safe and well tolerated, but artemether as an adjunct to risperidone does not appear to alleviate cognitive deficits of schizophrenia. Trial Registration Chinese Clinical Trial Register (ChiCTR) TRC-13003145.
authors.affiliation: Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Wang
authors.affiliation: Faculty of Health Sciences, University of Macau, Macao SAR, China; Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China. Electronic address: xyutly@gmail.com.
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xiang
authors.affiliation: Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
authors.forename: Qiu-Ying
authors.initials: QY
authors.lastname: Li
authors.affiliation: Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
authors.forename: Zhong-Chun
authors.initials: ZC
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
authors.forename: Shi-Sheng
authors.initials: SS
authors.lastname: Hao
authors.affiliation: Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
authors.forename: Lin-Lin
authors.initials: LL
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China; Hubei Institute of Neurology and Psychiatry Research, Wuhan, Hubei Province, China. Electronic address: wanggaohuad@tom.com.
authors.forename: Gao-Hua
authors.initials: GH
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, MaoJian Hospital of Shiyan, Shiyan, Hubei Province, China.
authors.forename: De-Gang
authors.initials: DG
authors.lastname: Wang
authors.affiliation: Department of Laboratory Science, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
authors.forename: Ping-An
authors.initials: PA
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Science, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
authors.forename: An-Yu
authors.initials: AY
authors.lastname: Bao
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Helen F K
authors.initials: HF
authors.lastname: Chiu
authors.affiliation: School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia; The University of Notre Dame Australia/Marian Centre, Perth, Australia.
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Kelly Y C
authors.initials: KY
authors.lastname: Lai
authors.affiliation: Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Buchanan
mesh_terms: D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D000077549:Artemether; D037621:Artemisinins / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D012559:Schizophrenia / Q000097:blood / Q000150:complications / Q000469:parasitology; D018709:Statistics, Nonparametric; D014122:Toxoplasma / Q000472:pathogenicity*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D037621:Artemisinins; D000077549:Artemether
keywords: Artemether; Cognition; Psychopathology; Schizophrenia; Toxoplasma gondii