| Schizophrenia is a group of severe chronic mental disorders of unknown etiology.It is manifested as abnormalities in mental activities such as cognition,thinking,emotions,behaviors,etc.It is more slowly onset than in early adulthood(16-25 years old),and the course of the disease is chronic.The tendency to change and mental decline can lead to significant impairment of professional and social functions.The treatment of schizophrenia is mainly antipsychotics,supplemented by psychosocial intervention.At present,the correlation between mental disorders and the immune system has received widespread attention.At present,more and more research evidence shows the value of anti-inflammatory drugs in mental disorders.Celecoxib is a new generation of the most widely used non-steroidal anti-inflammatory drug.It inhibits prostaglandin production by inhibiting cyclooxygenase-2(COX-2).Prostaglandins further regulate glutamate energy neurotransmission is involved in regulating the inflammatory response;currently there are literatures that compared with the placebo control group,celecoxib combined with antipsychotic drugs has a better effect on patients' mental symptoms and cognitive functions,and there is no significant increase in adverse reactions.Objective:In this study,We conducted a 6-week,randomized,controlled clinical trial of celecoxib(0.2 g,twice per day)as an adjunctive therapy in patients with schizophrenia to examine celecoxib's effects on psychopathology,cognition and cytokine levels.Method:This study conducted at the Jingzhou mental health hospital,Jingzhou City.72 inpatients were selected between June 01,2019 and November 30,2019.All patients met the Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-V)criteria.Patients were allocated in a random fashion,36 to risperidone plus celecoxib and 36 to risperidone.The psychotic symptoms were evaluated with the Positive and Negative Syndrome Scale(PANSS).The repeatable battery for the assessment of neuropsychological status(RBANS)were used to measure cognitive status.The serum levels of TNF-?,CRP,IL-1,IL-4 and IL-6 of the subjects were detected by enzyme-linked immunosorbent assay(ELISA).All patients provided written informed consent and this study protocol was approved by the ethics committee of Jingzhou mental health hospital.Results:Although both protocols significantly decreased the score of the positive,negative,general psychopathological symptoms and RBANS over the trial period.There was no significant change in any of the rating scales at week 6.However,there was a trend decrease in the Positive and Negative Syndrome Scale total score,and trend improvement in the RBANS total score.After 6 weeks of treatment,the levels of inflammatory cytokines IL-1,IL-4,IL-6 and CRP decreased in the peripheral blood of patients in the Celecoxib group,and there were significant differences(P<0.05),and TNF-? decreased,but no statistical difference(P>0.05).The levels of inflammatory cytokines IL-1,IL-4,IL-6,TNF-? and CRP increased in the peripheral blood of the control group,and there were significant differences(P<0.05).The change in peripheral blood IL-4 in the control group was positively correlated with the change in attention score,the change in peripheral blood TNF-? in the control group was positively correlated with the change in total PANSS score,and the change in peripheral blood CRP in the control group was positively correlated with the change in language,attention,delayed memory,and total score of RBANS.The change of IL-4 in the peripheral blood of patients in the celecoxib group was positively correlated with the change in PANSS general pathology score and PANSS total score.No relevant trends were found for other blood inflammatory factors.Conclusion:Celecoxib does not significantly increase the efficacy of risperidone in patients with relapsed schizophrenia on psychopathology and cognition.Celecoxib combined with risperidone can significantly improve the level of inflammatory cytokines in patients with relapsed schizophrenia,and promote the recovery of inflammation in the body.The results of this study suggest that celecoxib may be an effective adjuvant agent in the management of patients with chronic schizophrenia and anti-inflammatory therapies should be further investigated. |
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