acyclovir and Schizophrenia

To test our hypothesis that valacyclovir, an antiherpes virus-specific medication, added to antipsychotics (APs) would improve cognitive performance and psychopathology among schizophrenia subjects exposed to neurotropic herpes simplex virus, type 1 (HSV1).. Using a double-blind placebo-controlled design, we randomized 24 HSV1-seropositive schizophrenia subjects to receive either valacyclovir (n = 12) or placebo (n = 12) for 18 weeks in addition to stable doses of APs. Valacyclovir dose was stabilized at 1.5 g twice daily orally. At each visit, subjects were evaluated for severity of psychopathology and side effects using standardized scales and a study-specific semistructured checklist. A computerized neurocognitive battery validated on both schizophrenia and healthy subjects was administered at baseline and follow-up. Intent-to-treat analysis, using linear regression models that included all randomized subjects, were used to examine differential changes in cognition and psychopathology scores over 18 weeks between valacyclovir and placebo, accounting for placebo response.. Valacyclovir group improved in verbal memory, working memory, and visual object learning compared with placebo group. The effect sizes (Cohen's d) were 0.79 for working memory, 1.14 for immediate verbal memory, and 0.97 for the visual object learning. Psychotic symptom severity did not improve.. Supplemental valacyclovir may alleviate impairments in cognitive domains that are often observed in schizophrenia but not psychotic symptoms in those exposed to HSV1. If replicated, this approach could provide a novel strategy to treat cognitive impairments in a subgroup of schizophrenia subjects who can be reliably identified using a blood test.

Topics: Acyclovir; Adolescent; Adult; Antipsychotic Agents; Antiviral Agents; Cognition Disorders; Double-Blind Method; Drug Therapy, Combination; Female; Herpes Simplex; Herpesvirus 1, Human; Humans; Learning; Male; Memory, Short-Term; Middle Aged; Neuropsychological Tests; Psychotic Disorders; Schizophrenia; Valacyclovir; Valine; Young Adult

To investigate if adjunctive valacyclovir, an antiviral medication, reduces symptoms of persistent schizophrenia in individuals who are seropositive for cytomegalovirus (CMV).. N=47 CMV seropositive schizophrenia outpatients were randomly assigned to receive valacyclovir 1 g twice daily (n=24) or placebo (n=23) for 16 weeks after a 2-week placebo run-in. Symptoms were assessed biweekly.. There was no significant difference in the change of positive, negative, general, or total PANSS symptoms between the valacyclovir vs. the placebo group.. The study did not demonstrate benefit of adjunctive valacyclovir for schizophrenia individuals with persistent symptoms who are CMV seropositive.

Topics: Acyclovir; Adult; Antipsychotic Agents; Antiviral Agents; Baltimore; Comorbidity; Cytomegalovirus Infections; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology; Valacyclovir; Valine

The study was an investigation of the effect of the antiviral medication valacyclovir on the symptoms of outpatients with persistent schizophrenia.. Oral valacyclovir, 1 g twice daily, was administered to 65 outpatients over 16 weeks along with their usual psychiatric medications. Changes in psychiatric symptoms were measured with the Positive and Negative Syndrome Scale and were tested for correlations with antibodies to potentially neurotropic human herpesviruses, as measured by immunoassay before the start of the therapy.. There was a significant improvement in the psychiatric symptoms of individuals who were seropositive for cytomegalovirus. Improvement was not associated with antibodies to other herpesviruses or to a range of demographic and clinical variables.. The replication of cytomegalovirus may contribute to the symptoms of schizophrenia in some individuals.

Topics: Acyclovir; Adult; Antiviral Agents; Cytomegalovirus Infections; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prodrugs; Psychiatric Status Rating Scales; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology; Treatment Outcome; Valacyclovir; Valine

Topics: Acyclovir; Antiviral Agents; Cerebrospinal Fluid; Diagnosis, Differential; Encephalitis, Herpes Simplex; Female; Herpesviridae; Herpesviridae Infections; Humans; Polymerase Chain Reaction; Schizophrenia; Schizophrenic Psychology; Spirituality; Young Adult

Topics: Acyclovir; Adult; Female; Herpesviridae Infections; Herpesvirus 4, Human; Humans; Male; Schizophrenia