Background: Approximately one-third of people with schizophrenia have elevated levels of anti-gliadin antibodies of the immunoglobulin G type (AGA IgG) — a higher rate than seen in healthy controls. We performed the first double-blind clinical trial of gluten-free versus gluten-containing diets in a subset of patients with schizophrenia who were positive for AGA IgG. Methods: In this pilot feasibility study, 16 participants with schizophrenia or schizoaffective disorder who had elevated AGA IgG (≥ 20 U) but were negative for celiac disease were admitted to an inpatient unit for a 5-week trial. All participants received standardized gluten-free meals and were randomized in a double-blind fashion to receive a shake containing 10 g of gluten flour or 10 g of rice flour each day. Participants were rated for psychiatric, cognitive and gastrointestinal symptoms at baseline and endpoint. Results: Of the 16 participants, 14 completed the 5-week trial (2 discontinued early for administrative reasons). Compared with participants on the gluten-containing diet, participants on the gluten-free diet showed improvement on the Clinical Global Impressions scale (Cohen d = –0.75) and in negative symptoms (Cohen d = –0.53). We noted no improvement in positive or global cognitive symptoms, but did observe an improvement in attention favouring the gluten-free diet (Cohen d = 0.60). Robust improvements in gastrointestinal adverse effects occurred in the gluten-free group relative to the glutencontaining group. Adverse effects were similar between groups. Limitations: This study was limited by its small sample size; larger studies are needed. Conclusion: This feasibility study suggests that removal of gluten from the diet is associated with improvement in psychiatric and gastrointestinal symptoms in people with schizophrenia or schizoaffective disorder.
RCT Entities:
Background: Approximately one-third of people with schizophrenia have elevated levels of anti-gliadin antibodies of the immunoglobulin G type (AGA IgG) — a higher rate than seen in healthy controls. We performed the first double-blind clinical trial of gluten-free versus gluten-containing diets in a subset of patients with schizophrenia who were positive for AGA IgG. Methods: In this pilot feasibility study, 16 participants with schizophrenia or schizoaffective disorder who had elevated AGA IgG (≥ 20 U) but were negative for celiac disease were admitted to an inpatient unit for a 5-week trial. All participants received standardized gluten-free meals and were randomized in a double-blind fashion to receive a shake containing 10 g of gluten flour or 10 g of rice flour each day. Participants were rated for psychiatric, cognitive and gastrointestinal symptoms at baseline and endpoint. Results: Of the 16 participants, 14 completed the 5-week trial (2 discontinued early for administrative reasons). Compared with participants on the gluten-containing diet, participants on the gluten-free diet showed improvement on the Clinical Global Impressions scale (Cohen d = –0.75) and in negative symptoms (Cohen d = –0.53). We noted no improvement in positive or global cognitive symptoms, but did observe an improvement in attention favouring the gluten-free diet (Cohen d = 0.60). Robust improvements in gastrointestinal adverse effects occurred in the gluten-free group relative to the glutencontaining group. Adverse effects were similar between groups. Limitations: This study was limited by its small sample size; larger studies are needed. Conclusion: This feasibility study suggests that removal of gluten from the diet is associated with improvement in psychiatric and gastrointestinal symptoms in people with schizophrenia or schizoaffective disorder.
Authors: Daniela Čiháková; William W Eaton; Monica V Talor; Uasim H Harkus; Haley K Demyanovich; Katrina Rodriguez; Stephanie Feldman; Deanna L Kelly Journal: Schizophr Res Date: 2017-09-06 Impact factor: 4.939
Authors: Elaine Weiner; Robert R Conley; M Patricia Ball; Stephanie Feldman; James M Gold; Deanna L Kelly; Ikwunga Wonodi; Robert P McMahon; Robert W Buchanan Journal: Neuropsychopharmacology Date: 2010-07-21 Impact factor: 7.853
Authors: Deanna L Kelly; Haley K Demyanovich; William W Eaton; Nicola Cascella; Jessica Jackson; Alessio Fasano; William T Carpenter Journal: Brain Behav Immun Date: 2017-10-23 Impact factor: 7.217
Authors: Laura M Rowland; Haley K Demyanovich; S Andrea Wijtenburg; William W Eaton; Katrina Rodriguez; Frank Gaston; Daniela Cihakova; Monica V Talor; Fang Liu; Robert R McMahon; L Elliot Hong; Deanna L Kelly Journal: Front Psychiatry Date: 2017-06-19 Impact factor: 4.157
Authors: C Renay Friendshuh; Ana Pocivavsek; Haley Demyonovich; Katrina M Rodriguez; Daniela Cihakova; Monica V Talor; Charles M Richardson; Gopal Vyas; Heather A Adams; Annalisa B Baratta; Alessio Fasano; Nicola Cascella; Stephanie Feldman; Fang Liu; Mackenzie Sayer; Megan M Powell; Heidi J Wehring; Robert W Buchanan; William T Carpenter; William W Eaton; Deanna L Kelly Journal: J Clin Psychopharmacol Date: 2020 May/Jun Impact factor: 3.118