Music therapy improves schizophrenia

London: Music therapy for psychiatric in-patients with schizophrenia can improve some of the symptoms of the disorder, according to a new study by researchers at Imperial College London and therapists at the Central and North West London Mental Health Trust.

The preliminary research, published today in the British Journal of Psychiatry, is the first time music therapy for people with acute schizophrenia has been evaluated.

For this small study, 81 in-patients at four hospitals in central and inner London were randomised to receive music therapy or standard care alone. Those people receiving music therapy had between 8 and 12 sessions, once a week, for up to 45 minutes.

During the sessions patients were given access to a range of musical instruments and encouraged to use them to express themselves. Initially the therapist listened carefully to the patient’s music and accompanied them closely, seeking to follow their emotional state in musical terms. The therapist then offered opportunities to extend or vary the nature of the musical interaction.

The researchers measured symptoms of schizophrenia and found that improvements were greater among those people receiving music therapy than among those receiving standard care alone. Referral for music therapy was associated with reductions in general symptoms, such as depression and anxiety, and the negative symptoms of schizophrenia, such as emotional withdrawal. However, the authors caution that because this was a small study, it is possible that other factors, such as severity of illness, may have influenced the study’s findings.

Dr Mike Crawford, from the Department of Psychological Medicine at Imperial College London and lead author of the study, said: “We have known for some time that psychological treatments can help people with schizophrenia, but these have only been used when people are fairly stable. This study shows that music therapy provides a way of working with people when they are acutely unwell.

“At such times patients may find it difficult to express themselves using words, but through the skill of the therapist it may be possible to help people interact through music in a way that is constructive, creative and enjoyable,” he added.

The researchers believe that the study provides sufficient evidence to justify a larger explanatory randomised trial of music therapy for people with schizophrenia, designed to explore the effects and cost-effectiveness of this kind of therapy.

Dr Crawford explained: “In-patient treatment is the form of care that people with schizophrenia are least satisfied with. Music therapy may provide a means of enhancing the effectiveness of in-patient treatment by reducing some of the symptoms of schizophrenia that respond least well to drug treatment.”


1. “An exploratory randomised controlled trial of music therapy
for inpatients with schizophrenia” British Journal of Psychiatry, 1 November 2006

Nakul Talwar(1), Mike J Crawford* (2), Anna Maratos (1), Ula Nur, Orri McDermott (1), Simon Proctor (3)
(1) Central and North West London Mental Health NHS Trust
(2) Department of Psychological Medicine, Imperial College London
(3) East London and the City NHS Mental Health Trust
* Corresponding author

2. Consistently rated in the top three UK university
institutions, Imperial College London is a world leading science-based university whose reputation for excellence in teaching and research attracts students (11,000) and staff (6,000) of the highest international quality. Innovative research at the College explores the interface between science, medicine, engineering and management and delivers practical solutions that enhance the quality of life and the environment – underpinned by a dynamic enterprise culture. Website:

FDA approves new drug for bipolar patients

London: AstraZeneca today announced that the US Food and Drug Administration (FDA) has approved SEROQUEL® (quetiapine fumarate) for the treatment of patients with depressive episodes associated with bipolar disorder.

SEROQUEL already is approved for the treatment of acute manic episodes associated with bipolar I disorder and for the treatment of schizophrenia.

SEROQUEL is now the first and only single medication approved by the FDA to treat both depressive and manic episodes associated with bipolar disorder. The FDA approval was based primarily on results from the clinical trial programme known as BOLDER (BipOLar DEpRession), which comprises the BOLDER I and BOLDER II studies.

In these studies, patients taking SEROQUEL showed an improvement in depressive symptoms starting at week one compared to those taking placebo, and this improvement continued throughout the eight-week study. The recommended dose is 300 mg once-daily, to be achieved by day four of treatment. More than seven million American adults are affected by bipolar disorder, a serious psychiatric condition also known as manic depressive illness.

Patients with bipolar disorder are symptomatic almost half of their lives, and approximately two-thirds of that time is spent in the depressed phase of the illness. For many people with bipolar disorder, the depressive symptoms are significantly more debilitating than the manic symptoms associated with the illness.

“The new indication for SEROQUEL provides physicians and their patients with a single medication to treat both the depressive and manic episodes associated with bipolar disorder,” said John Patterson, Executive Director Development, AstraZeneca.

“Treating acute bipolar disorder with a single medication may help patients adhere to their medication regimen.” Both studies in the BOLDER programme were double-blind, placebo-controlled trials of outpatients (N=1,045) with bipolar I or II disorder.

Patients were randomized to receive eight weeks of treatment with fixed doses of SEROQUEL® (300 mg or 600 mg) or placebo administered once-daily. Efficacy in bipolar depression was demonstrated in the studies at both 300 mg a day and 600 mg a day. No additional benefit was seen in the 600 mg a day dose groups. Therefore, the recommended dose is 300 mg once-daily, to be achieved by day four of treatment. SEROQUEL was generally well tolerated, with adverse event types similar to those seen in other clinical trials of SEROQUEL in bipolar mania and

The most frequent adverse events seen in the bipolar depression trials were dry mouth, sedation, somnolence, dizziness and constipation. Because the depressive symptoms associated with bipolar disorder are also seen in major depressive disorder, a proper diagnosis can be difficult to achieve. In fact, studies show that as many as 69 percent of people with bipolar disorder were misdiagnosed, with the most frequent misdiagnosis being major depressive disorder. This misdiagnosis can lead to unfocused treatment that may exacerbate the disease.

Beyond schizophrenia, bipolar mania and bipolar depression, the ongoing clinical development programme includes investigations of the use of SEROQUEL in bipolar maintenance. Regulatory filings for the treatment of schizophrenia with a sustained release formulation of quetiapine fumarate, SEROQUEL SR™, were submitted this year to regulatory authorities in the US, EU and other markets. Ongoing SEROQUEL SR™ clinical studies also cover major depressive disorder and generalized anxiety disorder. SEROQUEL is the number 1 prescribed atypical antipsychotic in the United States. With a well-established safety and efficacy profile, SEROQUEL has had more than 19 million patient exposures worldwide since its launch in 1997.

In 2005, global sales for SEROQUEL reached $2.8 billion.

Cat parasite and schizophrenia link

London: Researchers have found stronger evidence for a link between a parasite in cat faeces and undercooked meat and an increased risk of schizophrenia.

Research published today in Procedings of the Royal Society B, shows how the invasion or replication of the parasite Toxoplasma gondii in rats may be inhibited by using anti-psychotic or mood stabilising drugs.

The researchers tested anti-psychotic and mood stabilising medications used for the treatment of schizophrenia on rats infected with T. gondii and found they were as, or more, effective at preventing behaviourial alterations as anti-T. gondii drugs. This led them to believe that T. gondii may have a role in the development of some cases of schizophrenia.

Dr Joanne Webster from Imperial College London, and lead researcher
said: “Although we are certainly not saying that exposure to this parasite does definitely lead to the development of schizophrenia, this and previous studies do show there may be a link in a few individuals, providing new clues for how we treat toxoplasmosis and schizophrenia.”

Previous epidemiological and neuropathological studies have indicated some cases of schizophrenia may be associated with environmental factors, such as exposure to the parasite T. gondii. At the same time several of the medications used to treat schizophrenia have been shown to posess anti-parasitic and in particular anti-T.gondii properties.This led the authors to suspect that the anti-psychotic activity of these medications may be due in part to their inhibition of these parasites.

When the rats were given Haloperidol, an anti-psychotic, and Valporic acid, a mood stabiliser, the behavioural symptoms of T.gondii were reduced. They found the drugs were able to limit the ‘suicidal feline’attraction by which the rats became less aware of the dangers of cats.

Dr Joanne Webster added: “By showing that drugs used to treat schizophrenia affect the parasite T. gondii, this does provide further evidence for its role in the development of some cases schizophrenia. It may be that anti-psychotic drugs work partly by parasite inhibition, and this could lead to new medicine and treatment combinations.”

The researchers have already begun human clinical trials using anti-T. gondii treatments as adjunct therapies for schizophrenia with researchers at Johns Hopkins University.