Tag: Antipsychotic

Do Lipid Alterations Predate Antipsychotic Treatment in Adolescents with Early-Onset Pyschosis?

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Research Paper Title

Lipid alterations in adolescents with early-onset psychosis may be independent of antipsychotic medication.

Background

Dyslipidemia and insulin resistance (HOMA-IR) are cardiovascular risk factors prevalent in patients with psychosis.

Whether these factors are intrinsic or affected by lifestyle or antipsychotic medication (AP) is unclear.

Therefore, the researchers investigated lipid profiles, HOMA-IR, and psychotic phenotypes in patients aged 12-18 years with early-onset psychosis (EOP) with and without AP exposure.

Methods

The researchers measured fasting total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), triglycerides (TG), insulin, and glucose in patients with EOP (n = 39) and healthy controls (HC) (n = 66).

Diet information was not available. Negative symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS).

They used univariate analysis of variance to compare TC/HDL-C ratios and TG and HOMA-IR values, controlling for body mass index (BMI) and AP exposure.

They also assessed the explained variance of having EOP using multiple regression analysis.

Results

Patients with and without AP exposure had significantly higher TC/HDL-C (p = 0.003, p = 0.029) and TG values (p < 0.001, p = 0.021) than HC.

Significantly increased HOMA-IR scores were found only in AP-exposed patients (p = 0.037). EOP significantly increased the explained variance for TC/HDL-C and TG, but not for HOMA-IR.

Patients with a PANSS negative score > 21 had significantly higher levels of TG than those with low scores (p = 0.032).

Conclusions

The results suggest that lipid alterations predate AP treatment in adolescents with EOP.

Higher levels of negative symptoms and AP further increase metabolic risk.

The preliminary findings propose that subclinical dyslipidemia may be intrinsic to EOP.

Reference

Wedervang-Resell, K., Friis, S., Lonning, V., Smelror, R.E., Johannessen, C., Agartz, I., Ulven, S.M., Holven, K.B., Andreassen, O.A. & Myhre, A.M. (2019) Lipid alterations in adolescents with early-onset psychosis may be independent of antipsychotic medication. Schizophrenia Research. pii: S0920-9964(19)30546-8. doi: 10.1016/j.schres.2019.11.039. [Epub ahead of print].

Reduction of Plasma Procoagulant Activity in Patients with Schizophrenia during Pharmacotherapy

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Research Paper Title

[Reduction of plasma procoagulant activity in patients with schizophrenia during pharmacotherapy: thrombodynamic parameters of coagulation before and after treatment].

Background

To detect plasma procoagulant activity in patients with schizophrenia at admission to the hospital in a state of exacerbation before (point 1) and after (point 2) pharmacotherapy and evaluate plasma and platelet hemostasis abnormalities.

Methods

The study included 80 women, aged from 16 to 57 years, median age 28 years, with schizophrenia with continuous, paroxysmal-progressive or paroxysmal course (F20.00, F20.01, F20.02 according to ICD-10).

In 42 of 80 patients, depressive disorders in the structure of schizophrenia were observed. The thrombodynamic test (TD) was performed on T-2 Trombodynamis device according to the manufacturer’s instructions (Hemacore LLC, Moscow, Russia).

Blood for the TD test was taken in admission to the hospital (point 1) and on discharge (point 2). All patients received standard pharmacotherapy according to their condition.

Results

For the first time, it was established that in the whole group of patients (n=46) thrombodynamic indicators of the rate of growth of the clot: initial velocity (Vin), stationary velocity (Vst) and adjusted for spontaneous clots velocity (V) and the amount of clot for 30 minutes test TD (ClotSize, CS) were significantly higher compared to normal values.

The mean time of occurrence of spontaneous thrombosis (Tsp) was significantly less than 30 min (p<0.0001), indicating rapid, spontaneous thrombosis. Other parameters of TD did not differ significantly from the norm.

As a result of treatment, the initial growth rate of the clot from the activator (Vi) decreased from 58,5 μm/min to 54,5 μm/min; V speed from 37,4 μm/min to 33,5 μm/min; CS clot size from 1249 μm to 1219 μm; clot density – from 24 874 units up to 23 658 units. All these changes are significant.

Such dynamics of plasma haemostasis clearly indicates a significant decrease in the coagulation activity of the blood plasma of patients as a result of treatment.

An increase in the time of appearance of spontaneous clots after treatment (from 23.5 minutes to 30.5 minutes) indicates a decrease in the procoagulant activity of platelet microparticles after treatment, i.e. the reduction of platelet activation as a result of treatment.

Conclusions

The study has shown for the first time that treatment of patients with antidepressants and antipsychotics reduces the generation of spontaneous clots. The treatment of patients with schizophrenia is accompanied by a decrease in the activity of plasma and platelet haemostasis. This is of great practical importance, since hypercoagulation of spontaneous clots in schizophrenic patients aggravates their chronic inflammatory disorders and affects their resistance to treatment.

Reference

Brusov, O.S., Karpova, N.S., Faktor, M.I., Sizov, S.V. & Oleichik, I.V. (2019) [Reduction of plasma procoagulant activity in patients with schizophrenia during pharmacotherapy: thrombodynamic parameters of coagulation before and after treatment]. In Russian. Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova. 119(10):51-55. doi: 10.17116/jnevro201911910151.