Antipsychotic treatment is associated with inflammatory and metabolic biomarkers alterations among first-episode psychosis patients: A 7-month follow-up study

Early Interv Psychiatry. 2019 Feb;13(1):101-109. doi: 10.1111/eip.12457. Epub 2017 Jul 18.

Abstract

Aim: Second-generation antipsychotics are commonly used to treat schizophrenia, but may cause metabolic syndrome (MetS) in a subset of patients. The mechanisms of antipsychotic-related metabolic changes remain to be established, especially in first-episode psychosis (FEP) patients.

Methods: In the present study, we used a chip technology to measure metabolic (C-peptide, insulin, leptin, adiponectin and resistin) and inflammatory biomarkers (ferritin, interleukin-6, interleukin-1α, tumour necrosis factor-α and plasminogen activator inhibitor-1) in the serum samples of a population of FEP patients before and after 7 months of antipsychotic drug treatment, compared to control subjects (CS).

Results: The comparison of these markers in antipsychotic-naïve FEP patients (N = 38) and CS (N = 37) revealed significantly higher levels of ferritin (P = .004), and resistin (P = .03) and lower level of leptin (P = .03) among FEP patients group. Seven months of antipsychotic drug treatment in patients (N = 36) ameliorated clinical symptoms, but increased significantly body mass index (BMI; P = .002) and these changes were accompanied by increased levels of C-peptide (P = .03) and leptin (P = .02), as well as decreased level of adiponectin (P = .01).

Conclusions: Seven months of antipsychotic drug treatment suppressed the clinical symptoms of psychosis whereas caused imbalance in metabolic biomarkers and increased BMI. These findings provide insight into antipsychotic-induced MetS and refer to problems in insulin processing already present in the early stage of the chronic psychotic disorder.

Keywords: antipsychotic drug treatment; body mass index; first-episode psychosis; inflammatory biomarkers; metabolic biomarkers.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / blood
  • Adult
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use*
  • Biomarkers / blood*
  • Body Mass Index
  • C-Peptide / blood
  • Female
  • Ferritins / blood
  • Follow-Up Studies
  • Humans
  • Interleukin-1alpha / blood
  • Interleukin-6 / blood
  • Leptin / blood
  • Male
  • Psychotic Disorders / blood*
  • Psychotic Disorders / drug therapy*
  • Resistin / blood
  • Tumor Necrosis Factor-alpha / blood
  • Young Adult

Substances

  • ADIPOQ protein, human
  • Adiponectin
  • Antipsychotic Agents
  • Biomarkers
  • C-Peptide
  • Interleukin-1alpha
  • Interleukin-6
  • Leptin
  • RETN protein, human
  • Resistin
  • TNF protein, human
  • Tumor Necrosis Factor-alpha
  • Ferritins