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Effect of Red Yeast Rice on Cognitive Functioning in Schizophrenia: Data From a Pilot Study.

  • 2019-05
  • Journal of clinical psychopharmacology 39(3)
    • Antonio Bruno
    • Gianluca Pandolfo
    • Manuela Crucitti
    • Giulia Maria Troili
    • Fortunato Battaglia
    • Rocco Antonio Zoccali
    • Maria Rosaria Anna Muscatello

Study Design

Type
Clinical Trial
Population
35 schizophrenia outpatients (age range, 18-60 years) on stable antipsychotic treatment
Methods
Received red yeast rice at 200 mg/d (total monacolin K 11.88 mg/capsule) for 12 weeks; open design, no control group
Blinding
Open-label
Duration
12 weeks

Background

Cognitive deficits (CDs) in schizophrenia affect poor outcome and real-world community functioning. Because redox imbalance has been implicated, among other factors, in the pathophysiology of CDs, antioxidant compounds may have a beneficial effect in their treatment. Red yeast rice (RYR), besides its lipid-lowering effect, exhibit antioxidant and anti-inflammatory.

Methods

Thirty-five schizophrenia outpatients (age range, 18-60 years) on stable antipsychotic treatment and assessed by neuropsychological (Wisconsin Card Sorting Test [WCST], Verbal Fluency, and Stroop task) and psychodiagnostic instruments (Brief Psychiatric Rating Scale) received RYR at daily dosage of 200 mg/d (total monacolin K/capsule content, 11.88 mg) for 12 weeks.

Results

Red yeast rice supplementation significantly improved WCST "perseverative errors" (P = 0.015), "total errors" (P = 0.017, P = 0.001), and phonemic fluency test (P = 0.008); a trend for improvement on other WCST variables ("nonperseverative errors," "perseverative responses," and "categories") was observed. Effect sizes, according to Cohen's suggestions, were small in all explored cognitive dimensions. There were no significant change in clinical symptoms and no subject-reported adverse effects.

Conclusions

Despite several limitations (open design, lack of a control group, short period of observation, small sample size, mode of controlling patients' compliance, the lack of assessment of patients' functional improvement), results suggest that RYR supplementation may be a potentially promising strategy for addressing CDs in schizophrenia; further randomized, placebo-controlled studies are needed to better evaluate the potential role of RYR for the treatment of CDs in schizophrenia.

Research Insights

  • red yeast rice→Improved Delayed Memory

    a trend for improvement on other WCST variables ('nonperseverative errors', 'perseverative responses', and 'categories') was observed

    Effect
    Neutral
    Effect size
    Small
    Dose
    200 mg/d (total monacolin K/capsule content, 11.88 mg)
  • red yeast rice→Improved Executive Function

    a trend for improvement on other WCST variables ('nonperseverative errors', 'perseverative responses', and 'categories') was observed

    Effect
    Neutral
    Effect size
    Small
    Dose
    200 mg/d (total monacolin K/capsule content, 11.88 mg)
  • red yeast rice→Improved Phonemic Fluency

    Red yeast rice supplementation significantly improved ... and phonemic fluency test (P = 0.008)

    Effect
    Beneficial
    Effect size
    Small
    Dose
    200 mg/d (total monacolin K/capsule content, 11.88 mg)
  • red yeast rice→Improved Verbal Fluency

    phonemic fluency test (P = 0.008)

    Effect
    Beneficial
    Effect size
    Small
    Dose
    200 mg/d (total monacolin K/capsule content, 11.88 mg)
  • red yeast rice→Improved Wisconsin Card Sorting Test Performance

    a trend for improvement on other WCST variables ('nonperseverative errors,' 'perseverative responses,' and 'categories') was observed

    Effect
    Neutral
    Effect size
    Small
    Dose
    200 mg/d (total monacolin K/capsule content, 11.88 mg)
  • red yeast rice→Reduced Nonperseverative Error

    a trend for improvement on other WCST variables ('nonperseverative errors,' 'perseverative responses,' and 'categories') was observed

    Effect
    Neutral
    Effect size
    Small
    Dose
    200 mg/d (total monacolin K/capsule content, 11.88 mg)
  • red yeast rice→Reduced Perseverative Error

    Red yeast rice supplementation significantly improved WCST 'perseverative errors' (P = 0.015)

    Effect
    Beneficial
    Effect size
    Small
    Dose
    200 mg/d (total monacolin K/capsule content, 11.88 mg)
  • red yeast rice→Reduced Perseverative Response

    a trend for improvement on other WCST variables ('nonperseverative errors,' 'perseverative responses,' and 'categories') was observed

    Effect
    Neutral
    Effect size
    Small
    Dose
    200 mg/d (total monacolin K/capsule content, 11.88 mg)
  • red yeast rice→Reduced Psychiatric Symptom Severity

    There were no significant change in clinical symptoms

    Effect
    Neutral
    Effect size
    Small
    Dose
    200 mg/d (total monacolin K/capsule content, 11.88 mg)
  • red yeast rice→Reduced Psychiatric Symptoms

    There were no significant change in clinical symptoms

    Effect
    Neutral
    Effect size
    Small
    Dose
    200 mg/d (total monacolin K/capsule content, 11.88 mg)
  • red yeast rice→Reduced Total Wisconsin Card Sorting Test Error

    Red yeast rice supplementation significantly improved WCST ... 'total errors' (P = 0.017, P = 0.001)

    Effect
    Beneficial
    Effect size
    Small
    Dose
    200 mg/d (total monacolin K/capsule content, 11.88 mg)

Adverse Events Reported

  • red yeast rice→Overall tolerability

    no subject-reported adverse effects.

    Finding
    Reported
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