I don’t know of any drug that increases IQ by 10 points, but Evenamide was said to be helpful to cognition.
They are advancing it to stage 3 later this year I think, for treatment resistant schizophrenia. It will be an add on, not a stand alone.
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The death rate for Pimavanserin in Parkinson’s is lower than for quetiapine, apparently.
They have to treat psychosis in Parkinson’s patients, and I guess they usually do that with clozapine, but it’s off-label. Apparently they also use quetiapine or other APs, but all of these are risky in elderly patients. I suppose they use clozapine because it blocks less D2 than others.
Anyway it may be that Pimavanserin is safer than the alternatives, but the only way to know is to continue testing.
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okay. I just remember reading about a drug in development that was discontinued/dangerous for causing stomach problems in elderly patients (could be a delusion…). I guess it was useful for schizophrenia. I believe someday drugs will be available to help us with cognitive decline.
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There probably was a drug like that, maybe one of the early cholinergic drugs. Those have intestinal side effects because the receptors are expressed throughout the body.
They are still working on it though, one company has one that they are combining with a blocker for sites outside the brain, that’s in phase 2 I think, and one is Vanderbilt’s M4 drug, which is in phase 1.
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I found it. They both start with an E:
“It’s a pretty substantial effect,” Dunsire says. “The difference on the rating scales translates into what might be equivalent to maybe a 10 point change […] on an IQ scale.”
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My theory is that too much dopamine can cause delusions and hallucinations, but blocking it can be terrible for the brain.
Basically what needs to be done is a partial agonist that slows it down compared to completely stopping it. Then scientists can use this for a much safer model for drugs.
Think about how SSRIs were developed, MAOIs which were proven to be a completely dangerous drug if not carefully watched what was taken and eaten with it. Then they moved on to serotonin as the chemical that causes depression and other issues in the brain. Therefor making them pretty useless as they have a new drug proved to be safer and making the other drugs defunct.
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Here’s info on Karuna’s drug.
Looks pretty effective from what they have so far.
"Xanomeline has demonstrated efficacy in reducing psychosis and improving cognition in placebo-controlled human trials in both Alzheimer’s disease and schizophrenia. Xanomeline has been dosed to date in over 800 subjects and with 150 patients have been dosed for up to six months and a subset of these patients having been dosed for up to three years. In a double-blind, placebo-controlled monotherapy trial in schizophrenia patients, a significant 24-point reduction over placebo was observed in the Positive and Negative Symptom Scale (prespecified primary endpoint), a gold standard instrument used for FDA approval. Current antipsychotic medicines typically show a 5-10 pt change over placebo in trial of this type. In a Phase II study in Alzheimer’s, xanomeline demonstrated a robust, dose-dependent reduction in behavioral symptoms (e.g., hallucinations, delusions) and provided evidence of cognitive benefit. "
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Can’t wait for this to be released. It will make SGAs useless and it seems like this is a way safer drug.
Dopaminergic theory is not conclusive. There is a lack of evidences that it’s the real cause of psychosis. There is also a lack of understanding of how antipsychotics work. So, yeah, it’s possible a new antipsychotic that don’t affect dopamine will work.
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Probably alot safer than traditional AP’s too
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I have read that some of the genes involved in sz are dopamine related genes. But, not all. This would explain why dopamine blocking drugs work better in some people than others, and not at all in some.
I expect they will learn how to predict better who needs what medicine based on blood tests.
I also think eventually there will be more region selective drugs or drug delivery systems, targeting specific brain regions. But that could be awhile.
Still, I don’t think the pipeline looks too bad.
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What about acidic brain theory in bipolar and schizophrenia? How do I decrease or reduce the acidity of my brain? Is it possible to do naturally or do I need to wait for better meds and therapy? Thanks.
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Maybe baking soda?
@insidemind
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is my anti psychotic dangerous?
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I have read about the brain acidity theory and it seems promising, but I don’t know what would decrease brain acidity. As @Chess24 pointed out, maybe baking soda, but I don’t know if they have done any studies, even in mice, to see if that actually changes the brain’s pH. I’m skeptical, but I don’t think we know yet.
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All commercially available antipsychotics have been approved by the FDA, which means that they found the risk to be acceptable. No medication, even Tylenol, is without risk, but there is a risk of not being on the meds too.
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@Om_Sadasiva @anon57786250 Both your views arent mutually exclusive. Imagine an appartment building where the apartments on one floor keep catching fire. The owners discover that restricting oxygen in the rooms reduces fires so they make the whole floor without oxygen and everyone has to wear a mask. The fires stop but the cause was falty wiring all along.
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They already have those swab tests for genetic testing for medications. Those seem to work very well and are super accurate.
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@daydreamer how do you feel on the antipsychotic compared to off it?
Do you feel better or worse?
Which AP it is and what dose?
Which one are you on?