The Role of Total White Blood Cell Count in Antipsychotic Treatment for Patients with Schizophrenia

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BACKGROUND: Total white blood cell count (TWBCc), an index of chronic and low-grade inflammation, is associated with clinical symptoms and metabolic alterations in patients with schizophrenia. The effect of antipsychotics on TWBCc, predictive values of TWBCc for drug response, and role of metabolic alterations require further study.

METHODS: Patients with schizophrenia were randomized to monotherapy with risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone, perphenazine or haloperidol in a 6-week pharmacological trial. We repeatedly measured clinical symptoms, TWBCc, and metabolic measures (body mass index, blood pressure, waist circumference, fasting blood lipids and glucose). We used mixed-effect linear regression models to test whether TWBCc can predict drug response. Mediation analysis to investigate metabolic alteration effects on drug response.

RESULTS: At baseline, TWBCc was higher among patients previously medicated. After treatment with risperidone, olanzapine, quetiapine, perphenazine, and haloperidol, TWBCc decreased significantly (p < 0.05). Lower baseline TWBCc predicted greater reductions in Positive and Negative Syndrome Scale (PANSS) total and negative scores over time (p < 0.05). We found significant mediation of TWBCc for effects of waist circumference, fasting low-density lipoprotein cholesterol, and glucose on reductions in PANSS total scores and PANSS negative subscale scores (p < 0.05).

CONCLUSION: TWBCc is affected by certain antipsychotics among patients with schizophrenia, with decreases observed following short-term, but increases following long-term treatment. TWBCc is predictive of drug response, with lower TWBCc predicting better responses to antipsychotics. It also mediates the effects of certain metabolic measures on improvement of negative symptoms. This indicates that the metabolic state may affect clinical manifestations through inflammation.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

2023

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:22

Enthalten in:

Current neuropharmacology - 22(2023), 1 vom: 04., Seite 159-167

Sprache:

Englisch

Beteiligte Personen:

Zhang, Yamin [VerfasserIn]
Tao, Shiwan [VerfasserIn]
Coid, Jeremy [VerfasserIn]
Wei, Wei [VerfasserIn]
Wang, Qiang [VerfasserIn]
Yue, Weihua [VerfasserIn]
Yan, Hao [VerfasserIn]
Tan, Liwen [VerfasserIn]
Chen, Qi [VerfasserIn]
Yang, Guigang [VerfasserIn]
Lu, Tianlan [VerfasserIn]
Wang, Lifang [VerfasserIn]
Zhang, Fuquan [VerfasserIn]
Yang, Jianli [VerfasserIn]
Li, Keqing [VerfasserIn]
Lv, Luxian [VerfasserIn]
Tan, Qingrong [VerfasserIn]
Zhang, Hongyan [VerfasserIn]
Ma, Xin [VerfasserIn]
Yang, Fude [VerfasserIn]
Li, Lingjiang [VerfasserIn]
Wang, Chuanyue [VerfasserIn]
Zhao, Liansheng [VerfasserIn]
Deng, Wei [VerfasserIn]
Guo, Wanjun [VerfasserIn]
Ma, Xiaohong [VerfasserIn]
Zhang, Dai [VerfasserIn]
Li, Tao [VerfasserIn]

Links:

Volltext

Themen:

12794-10-4
2S3PL1B6UJ
Antipsychotic Agents
Antipsychotics
Benzodiazepines
Clinical Trial
Drug response
FTA7XXY4EZ
Glucose
Haloperidol
IY9XDZ35W2
Inflammation
J6292F8L3D
L6UH7ZF8HC
Metabolic alterations.
N7U69T4SZR
Olanzapine
Perphenazine
Quetiapine Fumarate
Randomized Controlled Trial
Risperidone
Schizophrenia
White blood cell

Anmerkungen:

Date Completed 23.11.2023

Date Revised 15.12.2023

published: Print

Citation Status MEDLINE

doi:

10.2174/1570159X21666230104090046

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM351117954