Effects of B Vitamins on Symptoms and Cognitive Functions in Schizophrenia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Abstract
Objective: Schizophrenia which is a chronic disabling burdensome psychotic disorder has been treated with different antipsychotic medications. Some studies have reported a possible correlation between deficiency in minerals, nutrients and vitamins — mainly group B vitamins — and the development of schizophrenia. In the present study, we aimed to examine the effect of the B vitamin group as an adjuvant treatment to antipsychotics in individuals with chronic schizophrenia.
Method: In a randomized, double-blind clinical trial study, involving two groups of 25 patients with chronic schizophrenia, we compared the effects of a 12-week adjuvant treatment with a combination of B vitamins — B1 (15mg), B2 (15mg), B6 (10mg), B12 (10µg) and nicotinamide (50 mg) — with a placebo. The impact on negative, positive and cognitive symptoms of schizophrenia was assessed for both groups before the intervention (T0) and at 4, 8 and 12 weeks after the intervention (T1, T2, and T3, respectively).
Results: Following the treatment, negative symptoms scores decreased in the treatment group at 12 weeks following the beginning of the treatment (F (4, 45) = 464.7, P < 0.0001). Although a trend toward improvement in positive symptoms and cognitive scores was seen, these changes were not significant.
Conclusion: Our results suggest that selecting the group B vitamins as an adjuvant treatment to the antipsychotics may have beneficial effects on improving negative symptoms of patients with chronic schizophrenia.
2. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1603-58.
3. Firth J, Stubbs B, Sarris J, Rosenbaum S, Teasdale S, Berk M, et al. The effects of vitamin and mineral supplementation on symptoms of schizophrenia: a systematic review and meta-analysis. Psychol Med. 2017;47(9):1515-27.
4. Charlson FJ, Ferrari AJ, Santomauro DF, Diminic S, Stockings E, Scott JG, et al. Global Epidemiology and Burden of Schizophrenia: Findings From the Global Burden of Disease Study 2016. Schizophr Bull. 2018;44(6):1195-203.
5. Lolk A. Neurokognitive lidelser. Diagnostic and statistical manual of mental disorders: American Psychiatric Association; 2013.
6. Habtewold TD, Rodijk LH, Liemburg EJ, Sidorenkov G, Boezen HM, Bruggeman R, et al. A systematic review and narrative synthesis of data-driven studies in schizophrenia symptoms and cognitive deficits. Transl Psychiatry. 2020;10(1):244.
7. McCutcheon RA, Keefe RSE, McGuire PK. Cognitive impairment in schizophrenia: aetiology, pathophysiology, and treatment. Mol Psychiatry. 2023;28(5):1902-18.
8. Keepers GA, Fochtmann LJ, Anzia JM, Benjamin S, Lyness JM, Mojtabai R, et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. Am J Psychiatry. 2020;177(9):868-72.
9. Health NCCfM. Psychosis and schizophrenia in adults: treatment and management. National Institute for Health and Care Excellence (UK). 2014.
10. Jauhar S, McKenna PJ, Radua J, Fung E, Salvador R, Laws KR. Cognitive-behavioural therapy for the symptoms of schizophrenia: systematic review and meta-analysis with examination of potential bias. Br J Psychiatry. 2014;204(1):20-9.
11. Zoupa E, Bogiatzidou O, Siokas V, Liampas I, Tzeferakos G, Mavreas V, et al. Cognitive Rehabilitation in Schizophrenia-Associated Cognitive Impairment: A Review. Neurol Int. 2022;15(1):12-23.
12. Levine J, Stahl Z, Sela BA, Ruderman V, Shumaico O, Babushkin I, et al. Homocysteine-reducing strategies improve symptoms in chronic schizophrenic patients with hyperhomocysteinemia. Biol Psychiatry. 2006;60(3):265-9.
13. Hill M, Shannahan K, Jasinski S, Macklin EA, Raeke L, Roffman JL, et al. Folate supplementation in schizophrenia: a possible role for MTHFR genotype. Schizophr Res. 2011;127(1-3):41-5.
14. Roffman JL, Lamberti JS, Achtyes E, Macklin EA, Galendez GC, Raeke LH, et al. Randomized multicenter investigation of folate plus vitamin B12 supplementation in schizophrenia. JAMA Psychiatry. 2013;70(5):481-9.
5. Cao B, Sun XY, Zhang CB, Yan JJ, Zhao QQ, Yang SY, et al. Association between B vitamins and schizophrenia: A population-based case-control study. Psychiatry Res. 2018;259:501-5.
16. Allott K, McGorry PD, Yuen HP, Firth J, Proffitt TM, Berger G, et al. The Vitamins in Psychosis Study: A Randomized, Double-Blind, Placebo-Controlled Trial of the Effects of Vitamins B(12), B(6), and Folic Acid on Symptoms and Neurocognition in First-Episode Psychosis. Biol Psychiatry. 2019;86(1):35-44.
17. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91.
18. Raven JC. Raven standard progressive matrices. Journal of cognition and development. 1938.
19. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13(2):261-76.
20. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-9.
21. Rostami R, Kazemi R, Khodaie-Ardakani MR, Sohrabi L, Ghiasi S, Sadat Kamali Z, et al. The Persian version of the Calgary Depression Scale for Schizophrenia (CDSS-P). Asian J Psychiatr. 2019;45:44-9.
22. Itokawa M, Miyashita M, Arai M, Dan T, Takahashi K, Tokunaga T, et al. Pyridoxamine: A novel treatment for schizophrenia with enhanced carbonyl stress. Psychiatry Clin Neurosci. 2018;72(1):35-44.
23. Mitra S, Natarajan R, Ziedonis D, Fan X. Antioxidant and anti-inflammatory nutrient status, supplementation, and mechanisms in patients with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 2017;78:1-11.
24. Mitchell ES, Conus N, Kaput J. B vitamin polymorphisms and behavior: evidence of associations with neurodevelopment, depression, schizophrenia, bipolar disorder and cognitive decline. Neurosci Biobehav Rev. 2014;47:307-20.
25. Brown HE, Roffman JL. Vitamin supplementation in the treatment of schizophrenia. CNS Drugs. 2014;28(7):611-22.
Files | ||
Issue | Vol 20 No 1 (2025) | |
Section | Original Article(s) | |
Keywords | ||
B Vitamins Clinical Trial Cognition Psychotic Disorder Schizophrenia |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |