olanzapine and Multiple-Sclerosis

The high efficacy of atypical antipsychotics (AAP) in treating diverse psychiatric disorders has been partly attributed to their capacity to curb neuroinflammation, a shared aspect of these diseases. These immunomodulatory properties of AAP have lately been explored in the context of multiple sclerosis (MS), an autoimmune demyelinating disease of the CNS.. This study aimed to review in vivo studies reporting on the therapeutic effects of AAP both in EAE, the main animal model of MS and in cuprizone-induced demyelination. For that matter we conducted a literature search and a screening process that eventually yielded 8 eligible studies.. All studies agreed on the efficiency of AAP to dramatically reduce EAE severity and delay its onset, while suppressing the production of numerous inflammatory cytokines. Clozapine showcased similar yet more intense effects than risperidone, quetiapine and olanzapine, significantly attenuating CD4 T cell infiltration and myeloid cell activation, while upregulating Tregs. Clozapine also downregulated chemokines responsible for the migration of immune cells in the CNS and caused dopamine receptor levels in the brain of EAE mice to rise.. Taken together, these findings unanimously attest to the anti-inflammatory and immunomodulatory properties of AAP, suggesting that their therapeutic potential expands beyond their current neuropsychiatric applications. Despite the salutary effects of AAP in MS reported in vivo, a clinical trial of clozapine on MS patients failed to confirm preclinical findings due to low acceptability of AAP and early participant withdrawal.. Although preclinical evidence unquestionably supports the multifaceted beneficial properties of AAP in MS, further investigation is required to elucidate the pharmacodynamic profile of these agents and allow for their proper clinical testing on MS patients.

Topics: Animals; Antipsychotic Agents; Clozapine; Encephalomyelitis, Autoimmune, Experimental; Humans; Mice; Multiple Sclerosis; Olanzapine; Quetiapine Fumarate

Topics: Adrenoleukodystrophy; Antidepressive Agents, Tricyclic; Antipsychotic Agents; Autoimmunity; Benzodiazepines; Diffuse Cerebral Sclerosis of Schilder; Encephalomyelitis, Acute Disseminated; Humans; Methylprednisolone; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Neuromyelitis Optica; Olanzapine; Pirenzepine; Pulse Therapy, Drug; Selective Serotonin Reuptake Inhibitors; T-Lymphocytes

Catatonia is a rare complication of multiple sclerosis (MS). We present a case of a 28-year-old inpatient with MS successfully treated with electroconvulsive therapy (ECT) after developing a catatonic syndrome. A subsequent relapse also responded to ECT, after which the patient received maintenance ECT for 13 months without complications. Follow-up 18 months later did not reveal any evidence of neurological deterioration. We conclude that ECT was a safe and effective treatment in this MS patient.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Catatonia; Disease Progression; Electroconvulsive Therapy; Humans; Male; Mood Disorders; Multiple Sclerosis; Olanzapine; Recurrence

There is retrospective evidence of a correlation between psychosis in multiple sclerosis (MS) patients and temporal lobe pathology. A 35-year-old woman with MS presented with psychosis. There was no concurrent history of medication/substance use or family history. Comparison with previous MRI scans showed significant progression of lesions within the periventricular white matter of the left temporal lobe. This case highlights the association of psychosis and MS progression with worsening of left temporal lobe lesions. Prospective studies are required to ascertain the extent to which left temporal lobe lesions are predictive of future psychosis.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Delusions; Excitatory Amino Acid Antagonists; Female; Hallucinations; Humans; Lamotrigine; Magnetic Resonance Imaging; Multiple Sclerosis; Olanzapine; Pain; Psychotic Disorders; Risperidone; Temporal Lobe; Triazines; Weight Gain