Abstract
The current inability of psychiatric medicine to objectively select the most appropriate treatment or to predict imminent relapse are major factors contributing to the severity and clinical burden of schizophrenia. We have previously used multiplexed immunoassays to show that schizophrenia patients have a distinctive molecular signature in serum compared with healthy control subjects. In the present study, we used the same approach to measure biomarkers in a population of 77 schizophrenia patients who were followed up over 25 months with four aims: (1) to identify molecules associated with symptom severity in antipsychotic naive and unmedicated patients, (2) to determine biomarker signatures that could predict response over a 6-week treatment period, (3) to identify molecular panels that could predict the time to relapse in a cross-sectional population of patients in remission and (4) to investigate how the biological relapse signature changed throughout the treatment course. This led to identification of molecular signatures that could predict symptom improvement over the first 6 weeks of treatment as well as predict time to relapse in a subset of 18 patients who experienced recurrence of symptoms. This study provides the groundwork for the development of novel objective clinical tests that can help psychiatrists in the clinical management of schizophrenia.
Highlights
Less than 50% of schizophrenia patients respond to an initial treatment with antipsychotic medication.[1,2] This is not surprising as most of the current antipsychotic medications used in the treatment of schizophrenia were discovered empirically based on serendipitous clinical observations and reverse pharmacology.[3]
The first stage was aimed at the identification of molecules that correlated with symptom severity in untreated schizophrenia patients
Non-compliance is a serious issue in the treatment of psychiatric conditions, such as schizophrenia given that this is the most common cause leading to psychotic relapse
Summary
Less than 50% of schizophrenia patients respond to an initial treatment with antipsychotic medication.[1,2] This is not surprising as most of the current antipsychotic medications used in the treatment of schizophrenia were discovered empirically based on serendipitous clinical observations and reverse pharmacology.[3] there is not sufficient understanding of the underlying pathophysiology of schizophrenia to inform diagnosis. It is perhaps not surprising that there is a low treatment response rate and a high rate of non-compliance often resulting in relapse.[4] reliable tests with a sound biological rationale to guide the treatment selection are needed, as recently suggested in the case of antidepressant research and development.[5]
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