A new Roche drug that treats the listlessness and apathy experienced by schizophrenics is “the most exciting development in the therapeutics of schizophrenia in a long time,” according to a top psychiatry researcher.
The researcher, Columbia University’s Jeffrey Lieberman, is excited because the new medicine, RG1678, works entirely differently from the drugs that preceded it, was designed rationally, and treats symptoms of the disease that current entrants don’t address.
Lieberman played a pivotal role in testing current big selling schizophrenia drugs such as Eli Lilly’s Zyprexa, Pfizer’s Geodon and Bristol-Myers Squibb and Otsuka’s Abilify. But he also ran a large clinical trial, run by the National Institutes of Health, that has been widely interpreted as meaning that advantages of these drugs, known as second-generation antipsychotics, are more limited than doctors originally thought.
RG1687 is a glycine reuptake inhibitor. it inhibits the re-absorption of glycine, a important neurotransmitter, thereby normalizing levels of glutamate, another brain chemical thought to be important in schizophrenia. Experts have been discussing boosting glycine for more than a decade. Lieberman emphasizes that these drugs were developed “rationally, as opposed to serendipitously.”
However, Lieberman cautions, longer studies are going to be critical in proving if this drug works. Roche, which released the results in a press release, says that bigger clinical trials are being conducted with the hope of filing for regulatory approval.
Roche’s medicine is important not just because it works in a new way, but also because it treats symptoms of schizophrenia that other medicines don’t. Most drugs are targeted against the so-called positive symptoms of schizophrenia, the obvious, acute problems like hallucinations. RG1678 is being tested as a treatment for the negative symptoms of the disease, which include apathy and poor or nonexistent social functioning. these problems can be debilitating for schizophrenic patients, who experience them very frequently. Roche hopes that the first use of RG1678 will be in patients who are on other schizophrenia drugs, but who need relief from the negative symptoms of the disease.
Although Roche said that patients who did not withdraw from the study had a significant reduction in negative symptoms, the drug did have side effects. There was a panic attack, a suicide attempt, and a case of anxiety in the drug group, and there was a dose-dependent decrease in hemoglobin that was not considered clinically significant.