TY - JOUR
T1 - Glyceryl Trinitrate in First Episode Psychosis Unmedicated with Antipsychotics; A Randomised Controlled Pilot Study
AU - Merritt, Kate
AU - Catalan Alcantara, Ana
AU - Cowley, Samuel
AU - Demjaha, Arsime
AU - Taylor, Matthew
AU - McGuire, Philip
AU - Cooper, Ruth
AU - Morrison, Paul
PY - 2020/4/5
Y1 - 2020/4/5
N2 - Background
There is a pressing need for new classes of treatment for psychosis. A key therapeutic target for novel compounds is the NMDA receptor, which may be modulated by nitric oxide donors such as sodium nitroprusside (SNP). Recent studies of SNP in patients with psychosis have mixed results, and the drug has to be administered intravenously. Glyceryl trinitrate (GTN) is a well-established cardiovascular medicine that is also a nitric oxide donor, and can be given orally.
Aims
We explored the safety and potential effects of GTN in unmedicated patients with a first episode of psychosis.
Methods
Single-centre, randomized, double-blind, placebo-controlled trial from December 2016 to April 2019 (ClinicalTrials.gov identifier: NCT02906553). Patients received 3 x sprays of GTN or placebo for 3 consecutive days, and re-assessed on Days 1,2,3,7. The primary outcome was cognition (Jumping to Conclusions task), secondary outcomes were symptoms (Positive and Negative Syndrome Scale (PANSS)), verbal memory (Hopkins Verbal Learning task), and mood (Bond–Lader Visual Analog Scales).
Results
Nineteen patients were randomised, thirteen participants were included in the analyses. Compared to placebo, GTN was well tolerated, but was not associated with significant effects on cognition, symptoms, or mood. Bayesian statistics indicate that our results were 2x more likely under the null hypothesis than the alternative hypothesis, providing anecdotal evidence that GTN does not improve psychotic symptoms.
Conclusions
We found no indication of an effect of GTN on symptoms of psychosis or cognition.
Funding
Guys & St Thomas’ Charity (EFT150704)
AB - Background
There is a pressing need for new classes of treatment for psychosis. A key therapeutic target for novel compounds is the NMDA receptor, which may be modulated by nitric oxide donors such as sodium nitroprusside (SNP). Recent studies of SNP in patients with psychosis have mixed results, and the drug has to be administered intravenously. Glyceryl trinitrate (GTN) is a well-established cardiovascular medicine that is also a nitric oxide donor, and can be given orally.
Aims
We explored the safety and potential effects of GTN in unmedicated patients with a first episode of psychosis.
Methods
Single-centre, randomized, double-blind, placebo-controlled trial from December 2016 to April 2019 (ClinicalTrials.gov identifier: NCT02906553). Patients received 3 x sprays of GTN or placebo for 3 consecutive days, and re-assessed on Days 1,2,3,7. The primary outcome was cognition (Jumping to Conclusions task), secondary outcomes were symptoms (Positive and Negative Syndrome Scale (PANSS)), verbal memory (Hopkins Verbal Learning task), and mood (Bond–Lader Visual Analog Scales).
Results
Nineteen patients were randomised, thirteen participants were included in the analyses. Compared to placebo, GTN was well tolerated, but was not associated with significant effects on cognition, symptoms, or mood. Bayesian statistics indicate that our results were 2x more likely under the null hypothesis than the alternative hypothesis, providing anecdotal evidence that GTN does not improve psychotic symptoms.
Conclusions
We found no indication of an effect of GTN on symptoms of psychosis or cognition.
Funding
Guys & St Thomas’ Charity (EFT150704)
KW - Nitric oxide donor
KW - NITRIC OXIDE
KW - sodium nitroprusside
KW - Psychosis
KW - schizophrenia
KW - Clinical trial
KW - glyceryl trinitrate
M3 - Article
SN - 0269-8811
JO - Journal of Psychopharmacology
JF - Journal of Psychopharmacology
ER -