COX-2 inhibitors as adjunctive therapy in schizophrenia

Norbert Müller, Martin T Strassnig, Marcus J. Schwarz, Markus Ulmschneider, Michael Riedel

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Cyclooxygenase-2 (COX-2) is constitutively expressed in the central nervous system, and is thought to have an important functional role therein. COX-2 interacts with neurotransmitters such as acetylcholine, 5-hydroxytryptamine and glutamate but is also involved in the regulation of the central nervous system immune system and in inflammation via the effects of prostaglandins, in particular prostaglandin E2. A general therapeutic effect of the COX-2 inhibitor celecoxib on symptoms of schizophrenia was observed during a prospective, randomised, double-blind study of celecoxib add-on treatment to the atypical antipsychotic risperidone. The results from this trial of adjunctive therapy with a COX-2 inhibitor in schizophrenia are encouraging, and the findings support the view that an immunological/inflammatory process is involved in the pathogenesis of the disease. The add-on to an antipsychotic design of the study was chosen due to ethical reasons; in less acute schizophrenic states a monotherapy with COX-2 inhibitors would be interesting. From a theoretical point of view, other psychiatric indications for selective COX-2 inhibitors are discussed. COX-2 inhibitors have failed to show therapeutic effects in Alzheimer's disease but studies from basic research and a clinical perspective suggest it has an effect on disturbed cognition. In depression, however, signs of inflammation have been described for many years. Although results of clinical studies with COX-2 inhibitors in depression are still lacking, clinical improvement of a depressive syndrome has been observed in patients who have been treated with the COX-2 inhibitor rofecoxib due to other indications. These preliminary clinical data are encouraging for clinical therapeutic effects of the selective COX-2 inhibitors in psychiatric disorders, although these effects have to be confirmed in larger clinical studies. 2004

Original languageEnglish
Pages (from-to)1033-1044
Number of pages12
JournalExpert Opinion on Investigational Drugs
Volume13
Issue number8
DOIs
StatePublished - Aug 1 2004
Externally publishedYes

Fingerprint

Cyclooxygenase 2 Inhibitors
Schizophrenia
Celecoxib
Therapeutic Uses
Cyclooxygenase 2
Therapeutics
Antipsychotic Agents
Psychiatry
Central Nervous System
Depression
Inflammation
Risperidone
Depressive Disorder
Double-Blind Method
Dinoprostone
Cognition
Acetylcholine
Prostaglandins
Neurotransmitter Agents
Glutamic Acid

Keywords

  • Cognition
  • COX-2
  • Cyclooxygenase
  • Depression
  • Immunology
  • Inflammation
  • Schizophrenia

ASJC Scopus subject areas

  • Pharmacology

Cite this

Müller, N., Strassnig, M. T., Schwarz, M. J., Ulmschneider, M., & Riedel, M. (2004). COX-2 inhibitors as adjunctive therapy in schizophrenia. Expert Opinion on Investigational Drugs, 13(8), 1033-1044. https://doi.org/10.1517/13543784.13.8.1033

COX-2 inhibitors as adjunctive therapy in schizophrenia. / Müller, Norbert; Strassnig, Martin T; Schwarz, Marcus J.; Ulmschneider, Markus; Riedel, Michael.

In: Expert Opinion on Investigational Drugs, Vol. 13, No. 8, 01.08.2004, p. 1033-1044.

Research output: Contribution to journalArticle

Müller, N, Strassnig, MT, Schwarz, MJ, Ulmschneider, M & Riedel, M 2004, 'COX-2 inhibitors as adjunctive therapy in schizophrenia', Expert Opinion on Investigational Drugs, vol. 13, no. 8, pp. 1033-1044. https://doi.org/10.1517/13543784.13.8.1033
Müller N, Strassnig MT, Schwarz MJ, Ulmschneider M, Riedel M. COX-2 inhibitors as adjunctive therapy in schizophrenia. Expert Opinion on Investigational Drugs. 2004 Aug 1;13(8):1033-1044. https://doi.org/10.1517/13543784.13.8.1033
Müller, Norbert ; Strassnig, Martin T ; Schwarz, Marcus J. ; Ulmschneider, Markus ; Riedel, Michael. / COX-2 inhibitors as adjunctive therapy in schizophrenia. In: Expert Opinion on Investigational Drugs. 2004 ; Vol. 13, No. 8. pp. 1033-1044.
@article{d6ebf8b188924e41a915a39f4b52c5a2,
title = "COX-2 inhibitors as adjunctive therapy in schizophrenia",
abstract = "Cyclooxygenase-2 (COX-2) is constitutively expressed in the central nervous system, and is thought to have an important functional role therein. COX-2 interacts with neurotransmitters such as acetylcholine, 5-hydroxytryptamine and glutamate but is also involved in the regulation of the central nervous system immune system and in inflammation via the effects of prostaglandins, in particular prostaglandin E2. A general therapeutic effect of the COX-2 inhibitor celecoxib on symptoms of schizophrenia was observed during a prospective, randomised, double-blind study of celecoxib add-on treatment to the atypical antipsychotic risperidone. The results from this trial of adjunctive therapy with a COX-2 inhibitor in schizophrenia are encouraging, and the findings support the view that an immunological/inflammatory process is involved in the pathogenesis of the disease. The add-on to an antipsychotic design of the study was chosen due to ethical reasons; in less acute schizophrenic states a monotherapy with COX-2 inhibitors would be interesting. From a theoretical point of view, other psychiatric indications for selective COX-2 inhibitors are discussed. COX-2 inhibitors have failed to show therapeutic effects in Alzheimer's disease but studies from basic research and a clinical perspective suggest it has an effect on disturbed cognition. In depression, however, signs of inflammation have been described for many years. Although results of clinical studies with COX-2 inhibitors in depression are still lacking, clinical improvement of a depressive syndrome has been observed in patients who have been treated with the COX-2 inhibitor rofecoxib due to other indications. These preliminary clinical data are encouraging for clinical therapeutic effects of the selective COX-2 inhibitors in psychiatric disorders, although these effects have to be confirmed in larger clinical studies. 2004",
keywords = "Cognition, COX-2, Cyclooxygenase, Depression, Immunology, Inflammation, Schizophrenia",
author = "Norbert M{\"u}ller and Strassnig, {Martin T} and Schwarz, {Marcus J.} and Markus Ulmschneider and Michael Riedel",
year = "2004",
month = "8",
day = "1",
doi = "10.1517/13543784.13.8.1033",
language = "English",
volume = "13",
pages = "1033--1044",
journal = "Expert Opinion on Investigational Drugs",
issn = "1354-3784",
publisher = "Taylor and Francis Ltd.",
number = "8",

}

TY - JOUR

T1 - COX-2 inhibitors as adjunctive therapy in schizophrenia

AU - Müller, Norbert

AU - Strassnig, Martin T

AU - Schwarz, Marcus J.

AU - Ulmschneider, Markus

AU - Riedel, Michael

PY - 2004/8/1

Y1 - 2004/8/1

N2 - Cyclooxygenase-2 (COX-2) is constitutively expressed in the central nervous system, and is thought to have an important functional role therein. COX-2 interacts with neurotransmitters such as acetylcholine, 5-hydroxytryptamine and glutamate but is also involved in the regulation of the central nervous system immune system and in inflammation via the effects of prostaglandins, in particular prostaglandin E2. A general therapeutic effect of the COX-2 inhibitor celecoxib on symptoms of schizophrenia was observed during a prospective, randomised, double-blind study of celecoxib add-on treatment to the atypical antipsychotic risperidone. The results from this trial of adjunctive therapy with a COX-2 inhibitor in schizophrenia are encouraging, and the findings support the view that an immunological/inflammatory process is involved in the pathogenesis of the disease. The add-on to an antipsychotic design of the study was chosen due to ethical reasons; in less acute schizophrenic states a monotherapy with COX-2 inhibitors would be interesting. From a theoretical point of view, other psychiatric indications for selective COX-2 inhibitors are discussed. COX-2 inhibitors have failed to show therapeutic effects in Alzheimer's disease but studies from basic research and a clinical perspective suggest it has an effect on disturbed cognition. In depression, however, signs of inflammation have been described for many years. Although results of clinical studies with COX-2 inhibitors in depression are still lacking, clinical improvement of a depressive syndrome has been observed in patients who have been treated with the COX-2 inhibitor rofecoxib due to other indications. These preliminary clinical data are encouraging for clinical therapeutic effects of the selective COX-2 inhibitors in psychiatric disorders, although these effects have to be confirmed in larger clinical studies. 2004

AB - Cyclooxygenase-2 (COX-2) is constitutively expressed in the central nervous system, and is thought to have an important functional role therein. COX-2 interacts with neurotransmitters such as acetylcholine, 5-hydroxytryptamine and glutamate but is also involved in the regulation of the central nervous system immune system and in inflammation via the effects of prostaglandins, in particular prostaglandin E2. A general therapeutic effect of the COX-2 inhibitor celecoxib on symptoms of schizophrenia was observed during a prospective, randomised, double-blind study of celecoxib add-on treatment to the atypical antipsychotic risperidone. The results from this trial of adjunctive therapy with a COX-2 inhibitor in schizophrenia are encouraging, and the findings support the view that an immunological/inflammatory process is involved in the pathogenesis of the disease. The add-on to an antipsychotic design of the study was chosen due to ethical reasons; in less acute schizophrenic states a monotherapy with COX-2 inhibitors would be interesting. From a theoretical point of view, other psychiatric indications for selective COX-2 inhibitors are discussed. COX-2 inhibitors have failed to show therapeutic effects in Alzheimer's disease but studies from basic research and a clinical perspective suggest it has an effect on disturbed cognition. In depression, however, signs of inflammation have been described for many years. Although results of clinical studies with COX-2 inhibitors in depression are still lacking, clinical improvement of a depressive syndrome has been observed in patients who have been treated with the COX-2 inhibitor rofecoxib due to other indications. These preliminary clinical data are encouraging for clinical therapeutic effects of the selective COX-2 inhibitors in psychiatric disorders, although these effects have to be confirmed in larger clinical studies. 2004

KW - Cognition

KW - COX-2

KW - Cyclooxygenase

KW - Depression

KW - Immunology

KW - Inflammation

KW - Schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=4344614138&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4344614138&partnerID=8YFLogxK

U2 - 10.1517/13543784.13.8.1033

DO - 10.1517/13543784.13.8.1033

M3 - Article

VL - 13

SP - 1033

EP - 1044

JO - Expert Opinion on Investigational Drugs

JF - Expert Opinion on Investigational Drugs

SN - 1354-3784

IS - 8

ER -