Potential action of betel alkaloids on positive and negative symptoms of schizophrenia: A review

Background: The Areca catechu Linn. is the fourth most used drug in the world after nicotine, ethanol and caffeine. This plant contains nine alkaloids with muscarinic and nicotinic action, which could have an antipsychotic effect. Aim: The aim of this work is reviewing literature data about the potential action of betel alkaloids on positive, negative and cognitive symptoms of schizophrenia. Method: We reviewed the clinical literature data since 1980 via a PubMed search for the terms: arecoline, arecaidine, guvacine, guvacoline, betel, Areca catechu, positive and negative symptoms, cognitive symptoms, psychosis and schizophrenia in combination. Conclusion: Male high consumption of betel had significantly lower positive symptoms than low consumers or non-betel users.