The following is a summary of “Impact of second-generation antipsychotics monotherapy or combined therapy in cytokine, lymphocyte subtype, and thyroid antibodies for schizophrenia: a retrospective study,” published in the October 2024 issue of Psychiatry by Guo et al.
Schizophrenia is linked to the immune system, but interactions between psychopharmacological drugs and immune responses in patients are largely unexplored.
Researchers conducted a retrospective study to determine the influence of second-generation antipsychotics (SGA) monotherapy and combined therapy on blood immunity biomarkers in patients with schizophrenia.
They retrospectively screened medical records of inpatients with schizophrenia from January 2019 to June 2023, between June 2023 and August 2023. They collected and analyzed demographic data, peripheral levels of cytokines (IL-2, IL-4, IL-6, TNF-α, INF-γ, and IL-17 A), lymphocyte subtype proportions (CD3+, CD4+, CD8+ T-cell, and natural killer (NK) cells), and thyroid autoimmune antibodies (thyroid peroxidase antibody (TPOAb) and antithyroglobulin antibody (TGAb)).
The results showed that 30 drug-naïve patients, 64 on SGA monotherapy (20 for first-episode schizophrenia, 44 for recurrent schizophrenia) for at least 1 week, 39 on combined therapies for recurrent schizophrenia (18 with antidepressants, 10 with benzodiazepines, and 11 with mood stabilizers) for at least 2 weeks, and 23 who had previously received SGA monotherapy (withdrawn for at least 2 weeks) were included despite specific medication. No difference in cytokines was found between the SGA monotherapy sub-groups (P>0.05). Notably, SGA monotherapy appeared to induce down-regulation of IFN-γ in both first (mean [95% CI]: 1.08 [0.14–2.01] vs. 4.60 [2.11–7.08], P=0.020) and recurrent (1.88 [0.71–3.05] vs. 4.60 [2.11–7.08], P=0.027) episodes compared to drug-naïve patients. However, lymphocyte proportions and thyroid autoimmune antibodies remained unchanged after at least 2 weeks of SGA monotherapy (P>0.05). In combined therapy groups, results mainly resembled those of SGA monotherapy for recurrent schizophrenia (P>0.05).
The study concluded that SGA monotherapy for schizophrenia likely fulfills its comfort role by modulating IFN-γ, and SGA combined therapy closely resembles monotherapy.
Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-06141-z#Abs1
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