Abstract
Antipsychotic pharmacotherapy is strongly obesogenic and is associated with increased oxidative stress in patients with schizophrenia. However, whether these changes reflect psychopathology, antipsychotic efficacy, or some other factor is not known. Our study aims to investigate the degree of oxidative stress in different BMI categories and to identify clinical symptomatology that may be paired with increased oxidative stress in a schizophrenia population. To this end, we performed a cross-sectional study and recruited 89 long-term inpatients with schizophrenia and collected the following variables: plasma malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx), routine biochemical analysis, and psychopathology through the Positive and Negative Syndrome Scale (PANSS). The results indicate that the levels of the lipid peroxidation product, MDA, were significantly higher in the high BMI group than the low (normal) BMI group. As expected, high BMI was associated with an atherogenic lipid profile; however, it was also associated with fewer psychopathological symptoms. Multiple regression analysis found that MDA levels, the PANSS general psychopathology subscore, and triglyceride levels (all p < 0.05) were independent contributors to the BMI in patients. These results suggested that oxidative stress may play an important role in antipsychotic-induced weight gain. Further investigations using the longitudinal design in first-episode schizophrenia patients are needed to explore the beneficial effect of antioxidants on the abnormal lipid metabolism mediated by antipsychotic treatment.
Highlights
Weight gain is a common side effect of antipsychotics, affecting 40–60% of schizophrenia patients[1,2]
The major findings of the present study on schizophrenia long-term inpatients are the following: (1) the levels of the lipid peroxidation product MDA were significantly higher in the high body mass index (BMI) group; (2) the high BMI group showed fewer psychopathological symptoms and a more atherogenic lipid profile; (3) BMI status, oxidative stress, lipid profiles, and clinical symptoms were tightly correlated
We found that the lipid peroxidation product MDA levels were significantly higher in the high BMI group and that MDA levels positively associated with BMI
Summary
Weight gain is a common side effect of antipsychotics, affecting 40–60% of schizophrenia patients[1,2]. Antipsychotic-induced weight gain is a leading cause of noncompliance, leading to increased risk for relapse[3,4]. Obesity is linked to greater morbidity, mortality, and decreased life expectancy due to an increased risk for cardiovascular and malignant disorders[5,6,7,8]. Being obese can affect psychological wellbeing, leading to lower quality of life[9]. Oxidative stress occurs when there is an overproduction of reactive oxygen species (ROS) or a deficiency of cellular antioxidant defense mechanisms[10,11]. Accumulating evidence suggests that increased oxidative stress may be involved in the pathophysiology of schizophrenia[12,13,14]
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