Aerobic exercise can improve the size and function of the brain, and now investigators want to know if it can also improve cognitive function in patients with schizophrenia who struggle with memory and attention problems.

In another related study funded by the National Institute of Mental Health, investigators want to know the potential of two drugs that may help patients avoid or reverse unhealthy weight gain associated with the antipsychotics they must take.

"We want to mitigate the modifiable risk factors that these patients have in abundance," says Dr. Joseph McEvoy, psychiatrist and I. Clark Case Chair in Psychotic Disorders at the Medical College of Georgia at Augusta University. MCG recently became a study site for the two trials funded by the NIMH and McEvoy is the site principal investigator.

New Interventions in Schizophrenia

Dr. David Kimhy, director of the Experimental Psychopathology Laboratory and program leader for New Interventions in Schizophrenia at Icahn School of Medicine at Mount Sinai, is the principal investigator on the Improving Cognition via Exercise in Schizophrenia, or ICE, trial.

ICE compares 12 weeks of aerobic exercise, including time on a treadmill, stationary bike and stair climber driven by active-play video games, three times weekly for an hour, with a stretch and toning program as the control group.

About 200 patients at five geographically diverse research sites across the nation are being enrolled in the first study to focus on the impact of exercise on cognitive and intellectual function in these patients, McEvoy says.

Dr. Fred Jarskog, research director of the North Carolina Psychiatric Research Center at the University of North Carolina School of Medicine, is the principal investigator on the Metformin and Lorcaserin for Weight Loss in People with Schizophrenia, or MELT trial.

MELT is enrolling 110 overweight patients nationally with schizophrenia or schizoaffective disorder, which can also have symptoms of depression or bipolar disorder. It's exploring the effectiveness, safety, and tolerability of the new weight-loss drug lorcaserin alone versus combining it with metformin, a longtime antidiabetic medication that reduces insulin resistance and is known to help people, including those with schizophrenia, lose weight.

Early death from common killers like cardiovascular disease, diabetes, and stroke, resulting from a variety of factors like the significant weight gain that can result from their antipsychotic medication, lack of consistent primary medical care and high rates of smoking, are problems McEvoy and his colleagues hope both exercise and better weight control will help address for patients.

One characteristic of the disease is that patients have difficulty sticking with regular activities, like exercise, even if they enjoy it, McEvoy notes, adding that he encourages all of his patients to be physically active. He hopes with enough objective evidence, ongoing programs will develop across the country that will provide the structure that helps patients live better and longer.