Adjunctive Telmisartan's Effects on Symptoms of Schizophrenia

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Telmisartan is an angiotensin II type one receptor blocker (ARB) that has been approved for treating hypertension, alone or in combination with other antihypertensive medications.
Telmisartan is an angiotensin II type one receptor blocker (ARB) that has been approved for treating hypertension, alone or in combination with other antihypertensive medications.

Adding telmisartan to treatment with olanzapine or clozapine may improve symptoms of schizophrenia, according to a study in Acta Psychiatrica Scandinavica.1

Telmisartan is an angiotensin II type one receptor blocker (ARB) that has been approved for treating hypertension, alone or in combination with other antihypertensive medications. ARBs have been shown to have both proinflammatory and anti-inflammatory effects.2-4

The reported study sought to determine whether that anti-inflammatory property might change clinical symptoms in patients with schizophrenia or schizoaffective disorder. The researchers also aimed to determine the effects of telmisartan on psychopathology and cognition in this population treated adjunctively with the agent for 12 weeks.

The researchers report that 43 patients completed the 12-week, randomized, double-blind, placebo-controlled trial: 22 were entered in the telmisartan 80 mg/day group and 21 in the placebo group. While there were no significant differences in the attributes of subjects in the two arms, the trial drug group tended to include more people using tobacco, a lower education level, and an earlier age of onset than the placebo arm of the study.

Psychopathology of the study subjects was measured at baseline with the Positive and Negative Syndrome Scale (PANSS) and the Scale for Assessment of Negative Symptoms (SANS) plus a battery of neuropsychological assessments.

After 12 weeks of treatment, the telmisartan group showed a significant decrease in the total PANSS score compared with the placebo group (mean standard deviation [SD]: 14.1±8.1 vs 0.4±7.5, P =.038, Cohen's d =.57). There were no significant differences between the two groups in PANSS subscale scores, SANS total score, or any cognitive measures (P >.100).

Disclosures 

Dr Fan has received research support or honoraria from Allergen, Janssen, Alkermes, Avanir, Neurocrine, and Boehringer Ingelheim. Dr Jarskog has received research support from Auspex/Teva, Boehringer Ingelheim, and Otsuka. Dr Freudenreich has received research support or honoraria from Avanir, Neurocrine, and Janssen. Dr Goff has received research support from Avanir. Dr Henderson has received research support from Otsuka. Drs. Song, Natarajan, and Shukair report no competing interests.

References

  1. Fan X, Song X, Zhao M et al. The effect of adjunctive telmisartan treatment on psychopathology and cognition in patients with schizophrenia [published online August 29, 2017].  Acta Psych Scandinavica 2017:1-8.
  2. Mehta PK, Griendling KK. Angiotensin II cell signaling: physiological an dpathological effects in the cardiovascular system. Am J Physiol Cell Physiol 2006;26:26.
  3. Navalkar S, Parthasarathy S, Santanam N, Kahn BV. Irbesartan, an angiotensin type I receptor inhibitor, regulates markers of inflammation in patients with premature atherosclerosis. J Am Coll Cardiol 2001;37:440-444.
  4. Takeda T, Hoshida S, Nishino M et al. Relationship between effects of statins, aspirin and angiotensin II modulators on high-sensitive C-reactive protein levels. Atherosclerosis 2003;169:155-158.
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