Effect of Cuscuta epithymum Acquainted with Risperidone on the Improvement of Clinical Symptoms and Cognitive Impairment in Patients with Schizophrenia: A Triple-Blind Randomized Placebo-Controlled Trial

  • Maedeh Parvizi Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • Farbod Fadai Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • Moahammad Reza Khodaei-Ardakani Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • Gholamreza Amin Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  • Leila Abdi Department of Traditional Medicine, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  • Mehdi Noroozi Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • Iman Ansari Medical Students Research Committee, Shahed University, Tehran, Iran http://orcid.org/0000-0001-9597-653X
Keywords: Schizophrenia, Cuscuta, Risperidone, Cognitive Impairment


Background: Cuscuta epithymum (CE) is an established medicinal herb utilized for treating psychosis in Persian medicine. The aim of this study was to investigate the effect of CE combined with risperidone on the clinical symptoms and the cognitive impairment in patients diagnosed with schizophrenia. Materials and Methods: In this triple-blind randomized placebo-controlled trial, the intervention group received a dose of 500 mg of CE in the form of a capsule to be taken twice a day accompanied by an appropriate dose of risperidone. The control group was presented with a placebo identical to that of the CE capsule plus the allocated dose of risperidone. The PANSS and SCoRS questionnaires were used to assess the status of subjects prior to the initiation of the intervention as well as being put to use at the end of the second, fourth, and eighth week post-intervention. Registering and recording intel concerning positive and negative symptoms felt by participants (PANNS), and a test to assess the cognitive impairment of the individuals. Results: After eight weeks of treatment, all negative and positive symptoms besides hostility and somatic concern exhibited a significant improvement in the CE group (P <0.05). In contrast, the CE placebo group displayed no substantial improvement in the cases of the positive, negative and general symptoms (P>0.05) regarding cognitive impairment, after eight weeks of treatment, all symptoms were greatly improved in the CE group (P<0.05), while the effect of the placebo  on the patients cognitive impairment remained mostly stationary (P>0.05). Consequently, after eight weeks after the intervention, we can determine that the CE treatment has been noticeably more effective at improving positive, negative and cognitive symptoms of patients with schizophrenia. Conclusion: The results of this study demonstrated that CE, possessing possible antioxidant and neuroprotective properties, safely improved the positive and negative symptoms, and cognitive impairment of patients with schizophrenia.[GMJ.2019;8:e1334] 


Kahn RS, Sommer IE, Murray RM, Meyer-Lindenberg A, Weinberger DR, Cannon TD, et al. Schizophrenia. Nat Rev Dis Primers. 2015 Nov 12;1:15067.



Abi-Dargham A. Schizophrenia: overview and dopamine dysfunction. J Clin Psychiatry. 2014 Nov;75(11):e31.



Xavier RM, Vorderstrasse A. Neurobiological Basis of Insight in Schizophrenia: A Systematic Review. Nurs Res. 2016 May-Jun;65(3):224-37.



Meltzer HY. New Trends in the Treatment of Schizophrenia. CNS Neurol Disord Drug Targets. 2017;16(8):900-906.



Stroup TS, Gray N. Management of common adverse effects of antipsychotic medications. World Psychiatry. 2018;17(3):341-356.


PMid:30192094 PMCid:PMC6127750

Barron H, Hafizi S, Andreazza AC, Mizrahi R. Neuroinflammation and Oxidative Stress in Psychosis and Psychosis Risk. Int J Mol Sci. 2017 Mar 17;18(3). pii: E651.


PMid:28304340 PMCid:PMC5372663

Ghosian Moghadam M, Ansari I, Roghani M, Ghanem A, Mehdizade N. The Effect of Oral Administration of Hypericum Perforatum on Serum Glucose and Lipids, Hepatic Enzymes and Lipid Peroxidation in Streptozotocin-Induced Diabetic Rats. GMJ.2017;6(4):319-29.

Ghosian Moghaddam MH, Ansari I, Roghani M, Moradi M. The Effects of Origanum Majorana on Oxidative Stress and Histopathology of Renal Tissue among Streptozotocin-Induced Diabetic Rats. Thrita. 2013; 2(3): 29-34.


Abolhasanzadeh Z, Faridi P. Cuscuta epithymum, A Herbal Medicine and Parasite from Cuscutaceae Family. Journal of Islamic and Iranian Traditional Medicine. 2010; 1 (1) :73-75

Chabra A, Monadi T, Azadbakht M, Haerizadeh SI. Ethnopharmacology of Cuscuta epithymum: A comprehensive review on ethnobotany, phytochemistry, pharmacology and toxicity. J Ethnopharmacol. 2019 Mar 1;231:555-569.



Bhugra D. The global prevalence of schizophrenia. PLoS Med. 2005;2(5):e151-e175.


PMid:15916460 PMCid:PMC1140960

GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 [published correction appears in Lancet. 2017 Oct 28;390(10106):e38]. Lancet. 2017;390(10100):1211-1259.

American-Psychiatry-Association., Diagnostic and Statistical Manual of Mental Disorders,Text Revised (DSM-5). Fifth Edition. ed, ed. A.P. Association. 2013

Samadi R, Soluti S, Daneshmand R, Assari S, Manteghi AA. Efficacy of Risperidone Augmentation with Ondansetron in the Treatment of Negative and Depressive Symptoms in Schizophrenia: A Randomized Clinical Trial. Iran J Med Sci. 2017;42(1):14-23.

Nasrollahi N, Bigdelli I, Mohammadi MR, Hosseini SM. The Relationship between Obsessions and Compulsions and Negative and Positive Symptoms in Schizophrenia. Iran J Psychiatry. 2012;7(3):140-145.

Keefe RS, Poe M, Walker TM, Kang JW, Harvey PD. The Schizophrenia Cognition Rating Scale: an interview-based assessment and its relationship to cognition, real-world functioning, and functional capacity. Am J Psychiatry. 2006 Mar;163(3):426-32.



Mazhari S, Ghafaree-Nejad AR, Soleymani-Zade S, Keefe RSE. Validation of the Persian version of the Schizophrenia Cognition Rating Scale (SCoRS) in patients with schizophrenia. Asian J Psychiatr. 2017 Jun;27:12-15.



Zhang ZJ, Tan QR, Tong Y, Wang XY, Wang HH, Ho LM, et al. An epidemiological study of concomitant use of Chinese medicine and antipsychotics in schizophrenic patients: implication for herb-drug interaction. PLoS One. 2011 Feb 16;6(2):e17239.


PMid:21359185 PMCid:PMC3040227

Kumar A, Yadav M, Parle M, Dhingra S, Dhull DK. Potential drug targets and treatment of schizophrenia. Inflammopharmacology. 2017 Jun;25(3):277-292.



Yang AC, Tsai SJ. New Targets for Schizophrenia Treatment beyond the Dopamine Hypothesis. Int J Mol Sci. 2017 Aug 3;18(8). pii: E1689.


PMid:28771182 PMCid:PMC5578079

Forouzanfar F, Vahedi MM, Aghaei A, Rakhshandeh H. Hydroalcoholic extract of Cuscuta epithymum enhances pentobarbital-induced sleep: possible involvement of GABAergic system. Curr Drug Discov Technol. 2018 Nov 4.



Gupta M, Mazumder UK, Pal D, Bhattacharya S, Chakrabarty S. Studies on brain biogenic amines in methanolic extract of Cuscuta reflexa Roxb. and Corchorus olitorius Linn. seed treated mice. Acta Pol Pharm. 2003 May-Jun;60(3):207-10.

Moon M, Jeong HU, Choi JG, Jeon SG, Song EJ, Hong SP, et al. Memory-enhancing effects of Cuscuta japonica Choisy via enhancement of adult hippocampal neurogenesis in mice. Behav Brain Res. 2016 Sep 15;311:173-182.



Ibrahim M, Rehman K, Hussain I, Farooq T1, Ali B, Majeed I, et al. Ethnopharmacological Investigations of Phytochemical Constituents Isolated from the Genus Cuscuta. Crit Rev Eukaryot Gene Expr. 2017;27(2):113-150.



Kang SY, Jung HW, Lee MY, Lee HW, Chae SW, Park YK. Effect of the semen extract of Cuscuta chinensis on inflammatory responses in LPS-stimulated BV-2 microglia. Chin J Nat Med. 2014 Aug;12(8):573-81.


Magalhães PV, Dean O, Andreazza AC, Berk M, Kapczinski F. Antioxidant treatments for schizophrenia. Cochrane Database Syst Rev. 2016 Feb 5;2:CD008919.



How to Cite
Parvizi, M., Fadai, F., Khodaei-Ardakani, M. R., Amin, G., Abdi, L., Noroozi, M., & Ansari, I. (2019). Effect of Cuscuta epithymum Acquainted with Risperidone on the Improvement of Clinical Symptoms and Cognitive Impairment in Patients with Schizophrenia: A Triple-Blind Randomized Placebo-Controlled Trial. Galen Medical Journal, 8, e1334. https://doi.org/10.31661/gmj.v8i0.1334
Original Article