title: Drug repurposing and emerging adjunctive treatments for schizophrenia.
abstract: BACKGROUND
  Schizophrenia is a frequent disorder, which substantially impairs patients' quality of life. Moreover, the burden of illness for patients, their families and for the society, in general, is substantial. Nevertheless, the understanding of the pathophysiology of this syndrome, concise diagnostic methods and more effective and tolerable treatments are still lacking. Thus, innovative approaches and the exploration of new territories are required.
  
  
  METHODS
  An overview of repurposed drugs and emerging treatments for schizophrenia is presented, focusing on randomized, controlled trials and meta-analyses.
  
  
  CONCLUSIONS
  Despite many years of drug research, several needs in the treatment of schizophrenia including the safety and tolerability, stage-dependent and personalized approaches, as well as drug delivery and sustainability have not been addressed sufficiently. Given the current failure of a number of mechanistically new drugs, repurposed compounds may serve as alternative and/or adjunctive agents for schizophrenic patients and for treatment refractory patients in particular. Anti-inflammatory drugs (e.g., acetylsalicylic acid, celecoxib and minocycline), as well as N-acetylcysteine, a precursor of the major antioxidant glutathione, hormones (e.g., estrogen, raloxifene and oxytocin), glutamatergic (e.g., glycine and d-serine) and nicotinergic compounds, 'nutraceuticals' (e.g., ω-3 fatty acids) and cannabidiol, an endocannabinoidmodulator, represent promising agents in this field.
authors: Heidelberg University, Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim , J5, 68159 Mannheim , Germany +49 621 1703 2321 ; +49 621 1703 2325 ; leweke@cimh.de.
authors: Jan Malte
authors: JM
authors: Bumb
authors: Frank
authors: F
authors: Enning
authors: F Markus
authors: FM
authors: Leweke
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002185:Cannabidiol / Q000627:therapeutic use; D019587:Dietary Supplements; D058492:Drug Repositioning; D004359:Drug Therapy, Combination; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D015201:Meta-Analysis as Topic; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D014150:Antipsychotic Agents; D015525:Fatty Acids, Omega-3; D006728:Hormones; D002185:Cannabidiol; D000111:Acetylcysteine
keywords: antipsychotics; emerging drugs; new mechanisms; quality of life; repurposed drugs; schizophrenia; treatment resistance