Piracetam in the treatment of schizophrenia: implications for the glutamate hypothesis of schizophrenia

Objective: There is a growing interest in investigating the role of glutama te receptors in the pathophysiology of schizophrenia. Indeed, the hyperdopa minergic theory of schizophrenia can explain only the positive symptoms of schizophrenia, whereas the glutamate hypothesis may provide a more comprehe nsive view of the illness. We undertook a trial to investigate whether the combination of haloperidol with piracetam, a nootropic agent which modulate s the glutamate receptor positively was more effective than haloperidol alo ne. Methods: Thirty patients who met the DSM IV criteria for schizophrenia comp leted the study. Patients were allocated in a random fashion, 14 to haloper idol 30 mg/day plus piracetam 3200 mg/day and 16 to haloperidol 30 mg/day p lus placebo. Results: Although both protocols significantly decreased the score of the p ositive symptoms, the negative symptoms, the general psychopathological sym ptoms and the total score of PANSS scale over the trial period, the combina tion of haloperidol and piracetam showed a significant superiority over hal operidol alone in the treatment of schizophrenic patients. Conclusion: Piracetam, a member of the nootropic class of drugs and a posit ive modulator of glutamate receptor, may be of therapeutic benefit in treat ing schizophrenic patients in combination with typical neuroleptics, Howeve r, a larger study to confirm our results is warranted.