Oliver D Robertson1,2, Nieves G Coronado3, Rickinder Sethi4, Michael Berk1,2,5,6,7, Seetal Dodd1,2,5,6. 1. IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia. 2. Mental Health, Drugs and Alcohol Services, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia. 3. Unidad de Gestión Clinica Salud Mental, Hospital Universitario Virgen del Rocio, Sevilla, Spain. 4. Department of Psychiatry, Western University, London, Ontario, Canada. 5. Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia. 6. Mood Disorders Research Program, Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia. 7. Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.
Abstract
AIM: Neuropsychiatric disorders including depression, bipolar and schizophrenia frequently exhibit a neuroprogressive course from prodrome to chronicity. There are a range of agents exhibiting capacity to attenuate biological mechanisms associated with neuroprogression. This review will update the evidence for putative neuroprotective agents including clinical efficacy, mechanisms of action and limitations in current assessment tools, and identify novel agents with neuroprotective potential. METHOD: Data for this review were sourced from online databases PUBMED, Embase and Web of Science. Only data published since 2012 were included in this review, no data were excluded based on language or publication origin. RESULTS: Each of the agents reviewed inhibit one or multiple pathways of neuroprogression including: inflammatory gene expression and cytokine release, oxidative and nitrosative stress, mitochondrial dysfunction, neurotrophin dysregulation and apoptotic signalling. Some demonstrate clinical efficacy in preventing neural damage or loss, relapse or cognitive/functional decline. Agents include: the psychotropic medications lithium, second generation antipsychotics and antidepressants; other pharmacological agents such as minocycline, aspirin, cyclooxygenase-2 inhibitors, statins, ketamine and alpha-2-delta ligands; and others such as erythropoietin, oestrogen, leptin, N-acetylcysteine, curcumin, melatonin and ebselen. CONCLUSIONS: Signals of evidence of clinical neuroprotection are evident for a number of candidate agents. Adjunctive use of multiple agents may present a viable avenue to clinical realization of neuroprotection. Definitive prospective studies of neuroprotection with multimodal assessment tools are required.
AIM: Neuropsychiatric disorders including depression, bipolar and schizophrenia frequently exhibit a neuroprogressive course from prodrome to chronicity. There are a range of agents exhibiting capacity to attenuate biological mechanisms associated with neuroprogression. This review will update the evidence for putative neuroprotective agents including clinical efficacy, mechanisms of action and limitations in current assessment tools, and identify novel agents with neuroprotective potential. METHOD: Data for this review were sourced from online databases PUBMED, Embase and Web of Science. Only data published since 2012 were included in this review, no data were excluded based on language or publication origin. RESULTS: Each of the agents reviewed inhibit one or multiple pathways of neuroprogression including: inflammatory gene expression and cytokine release, oxidative and nitrosative stress, mitochondrial dysfunction, neurotrophin dysregulation and apoptotic signalling. Some demonstrate clinical efficacy in preventing neural damage or loss, relapse or cognitive/functional decline. Agents include: the psychotropic medications lithium, second generation antipsychotics and antidepressants; other pharmacological agents such as minocycline, aspirin, cyclooxygenase-2 inhibitors, statins, ketamine and alpha-2-delta ligands; and others such as erythropoietin, oestrogen, leptin, N-acetylcysteine, curcumin, melatonin and ebselen. CONCLUSIONS: Signals of evidence of clinical neuroprotection are evident for a number of candidate agents. Adjunctive use of multiple agents may present a viable avenue to clinical realization of neuroprotection. Definitive prospective studies of neuroprotection with multimodal assessment tools are required.
Authors: Rickinder Sethi; Nieves Gómez-Coronado; Adam J Walker; Oliver D'Arcy Robertson; Bruno Agustini; Michael Berk; Seetal Dodd Journal: Front Psychiatry Date: 2019-09-04 Impact factor: 4.157
Authors: Inger Hellerhoff; Joseph A King; Friederike I Tam; Sophie Pauligk; Maria Seidel; Daniel Geisler; Klaas Bahnsen; Nicole Kretschmann; Katja Akgün; Veit Roessner; Tjalf Ziemssen; Stefan Ehrlich Journal: Transl Psychiatry Date: 2021-02-09 Impact factor: 6.222
Authors: Anna Giménez-Palomo; Seetal Dodd; Gerard Anmella; Andre F Carvalho; Giselli Scaini; Joao Quevedo; Isabella Pacchiarotti; Eduard Vieta; Michael Berk Journal: Front Psychiatry Date: 2021-07-06 Impact factor: 4.157