Schizophrenia is a rare, complex and severe mental disorder affecting at least 0.3 percent of the US adult population. It affects how a person behaves, feels and thinks. A person also experiences agitated movements and a difficulty in performing daily activities. The usual course of treatment comprises psychosocial therapy and pharmacological agents like risperidone, clozapine, and brexpiprazole. However, some studies have demonstrated that at least one fifth or one-half of the patients are resistant to the pharmacological agents.
Recently, a study by the researchers of the China Medical University in Taiwan has established the effectiveness of a food preservative sodium benzoate in increasing the effectiveness of the drug clozapine. The researchers had conducted a placebo-controlled, double-blind randomized trial. Clozapine is the last line of drug used to manage schizophrenia and even then, many people are resistant to it. The new trial has established that sodium benzoate, which has been previously used with other antipsychotics, can be used to amplify the effects of the given antipsychotic for the benefit of patients with refractory schizophrenia. The study results have been published in the journal Biological Psychiatry.
Higher doses of sodium benzoate have no side effects
The study included 60 participants who received clozapine. The subjects were divided into three groups. The first group received placebo, and the second and third groups received one or two grams of clozapine per day along with sodium benzoate. The treatment was provided to the subjects for six weeks time.
In the group that received both forms of treatment, the authors noted an improvement in symptoms like anhedonia (loss of interest in the usual pleasurable activities), flat effect (impassive facial expressions) and difficulty in carrying out the normal activities. They also observed that a higher dose of sodium benzoate was more effective in boosting the treatment efficacy. However, no improvement was found in the cognitive symptoms pertaining to memory and maintaining focus. The researchers hypothesized that higher doses of sodium benzoate might be effective in bringing that change.
The research team was happy to note that none of the participants suffered from any side effects of sodium benzoate, which established that it can be used safely among the patients. The reason why sodium benzoate is effective is that it prevents D-serine which is a brain amino acid from breaking down. D-serine is a neuromodulator, which helps in the regulation of the transmission of electrical signals between the brain cells. These signals are impaired in people struggling with schizophrenia and sodium benzoate is perhaps the first molecule acting on these receptors effectively. According to the editor of Biological Psychiatry, Dr. John Krystal, “This study highlights the importance for schizophrenia treatment of understanding the molecular switches that can be thrown to normalize brain circuit function.”
Road to recovery
Antipsychotic medications are the most frequently prescribed drugs to manage schizophrenia. They help alleviate symptoms of hallucinations, delusions, loose associations and poor concentration. Additionally, supportive (reality-based) psychotherapy is a popular approach for treating patients with schizophrenia dealing with the loss, disability and stigma arising from living with the disease. It differs from other specific techniques, as it actively decreases the rigorousness of some of the core symptoms caused by the incapacity. Cognitive behavioral therapy (CBT) is also a common form of psychotherapy to bring relief. In CBT, a patient is able to receive instruction and guidance on identifying thoughts, perceptions, worldviews, and general thoughts and feelings that trigger symptoms of visual or auditory hallucinations. The therapist works with the patients to help them realize that their thoughts and emotions are only perceptions and not facts. Eventually, the patients are able to understand how to alter their perceptions of the world around them.
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