Changes in serum interleukin-2, -6, and -8 levels before and during treatment with risperidone and haloperidol: relationship to outcome in schizophrenia

BACKGROUND: Many studies have indicated that immune cytokines may be involved in the pathophysiology of schizophrenia. Recently, there have been reports that typical and atypical antipsychotic drugs may influence the levels of cytokines or cytokine receptors. The aim of this study was to compare the effect of typical and atypical antipsychotic drugs on serum interleukin-2 (IL-2), interleukin-6 (IL-6), and interleukin-8 (IL-8) and to investigate the relationship between the changes in cytokines and the therapeutic outcome in schizophrenia. METHOD: From April 1996 to August 1997, seventy-eight inpatients with a diagnosis of chronic schizophrenia (DSM-III-R) were randomly assigned to 12 weeks of treatment with 6 mg/day of risperidone or 20 mg/day of haloperidol. Clinical efficacy was determined using the Positive and Negative Syndrome Scale. Serum IL-2 was assayed by radioimmunometric assay, and serum IL-6 and IL-8 concentrations were measured by quantitative enzyme-linked immunosorbent assay in patients and 30 sex- and age-matched normal subjects. RESULTS: Both risperidone and haloperidol reduced the elevated serum IL-2 concentrations in schizophrenia, and no significant difference was noted in the reduction of serum IL-2 concentrations between risperidone and haloperidol treatment. Neither risperidone nor haloperidol showed significant influence on the higher serum IL-6 or IL-8 concentrations in schizophrenia. Correlations between serum IL-2 or IL-8 concentrations at baseline and the therapeutic outcome were observed, demonstrating that patients presenting with low concentrations of serum IL-2 or IL-8 at baseline showed greater improvement and patients presenting with higher serum IL-2 or IL-8 concentrations at baseline showed less improvement after treatment. CONCLUSIONS: Both typical and atypical anti-psychotic drugs may at least partially normalize abnormal immune alterations in schizophrenia. Some immune parameters at baseline may be useful for predicting the neuroleptic response of schizophrenic patients.     

Risperidone-induced increase in serum prolactin is correlated with positive symptom improvement in chronic schizophrenia

The elevation in serum prolactin (PRL) concentration in schizophrenic patients treated with typical antipsychotic drugs is well documented. Recently, increased prolactin levels have been reported in patients taking risperidone. The purpose of this study was to explore the effect of the atypical antipsychotic drug risperidone on serum prolactin, and to investigate the relationship between the change in PRL and the therapeutic outcome. In this study, 30 male inpatients with a diagnosis of chronic schizophrenia (DSM-III-R) were assigned to 12 weeks of treatment with risperidone after a 2-week washout period. The risperidone dose was fixed at 6 mg/day. Clinical efficacy was determined using the Positive and Negative Syndrome Scale (PANSS). Serum PRL was assayed in serum by radioimmunometric assay in schizophrenic patients before and after 12-week treatment, as compared to 30 age-matched normal male subjects. The results showed that risperidone treatment significantly increased the serum PRL. A significant and positive relationship between the change in PRL at pre- and post-treatment and the reduction rate of PANSS positive subscore was observed. Risperidone treatment significantly increased the serum PRL levels of schizophrenic patients. There was a close relationship between the improvement in positive symptoms and the change of serum PRL level before and after risperidone treatment. The serum PRL levels at baseline could be used to predict the responses of schizophrenic patients to risperidone.     

氯氮平、利培酮对精神分裂症患者白细胞介素-2的影响

目的 了解氯氮平、利培酮对首发精神分裂症偏执型患者血清白细胞介素-2(IL-2)的影响,并探讨IL-2与精神病理的关系。方法 对58例首发精神分裂症偏执型患者给予氯氮平或利培酮治疗,分别在治疗前和治疗后第4、8周末、6月末用酶联免疫吸附法检测血清IL-2水平,并用阳性和阴性症状量表(PANSS)评估精神症状及其变化。结果 两组患者治疗后第4、8周末血清IL-2水平均显著低于治疗前;不同药物对IL-2影响差异无显著性;治疗前IL-2水平与SPANSS总分、阳性症状分呈显著正相关;治疗后8周末血清IL-2减分值与阳性症状减分值呈显著正相关;利培酮组患者治疗后第8周末血清IL-2减分值与利培酮日量呈显著相关。结论 氯氮平和利培酮有相似的免疫抑制作用,血清IL-2与精神分裂症精神病理之间有一定的关系。     

COX-2 inhibition as a treatment approach in schizophrenia: Immunological considerations and clinical effects of celecoxib add-on therapy

Abstract. Recent advances in immunological research regarding the differentiation between the type-1 and type-2 immune response are discussed. Increased levels of Interleukin-6 (IL-6) and the activation of the IL-6 system in schizophrenia might be the result of the activation of type-2 monocytes/macrophages, too. On the contrary, several parameters of the specific cellular immune system are blunted, e. g. the decreased type-1 related immune parameters in schizophrenic patients. This study was performed as a double-blind, placebo-controlled, randomized evaluation of risperidone and celecoxib versus risperidone and placebo. Fifty schizophrenic patients were included in the study: 25 patients received risperidone and placebo, and 25 patients received risperidone and celecoxib for 5 weeks after the wash-out period. The treatment effect was calculated by ANCOVA. In parallel, serum levels of sTNF-R1 and sIL- 2R, and the percentages of CD3⁺-, CD4⁺-, and CD19⁺ lymphocytes were estimated. As expected, both groups of schizophrenic patients showed significant improvement. However, the celecoxib add-on therapy group showed a significant group effect in the PANSS total score. The cytokines and lymphocytes reflected the type-1/type-2 balancing effects of COX-2 inhibitors. Additional treatment with celecoxib has significant positive effects on the therapeutic action of risperidone with regard to the total schizophrenia psychopathology. Moreover, the fact that treatment with an immunomodulatory drug shows beneficial effects on the symptomatology of schizophrenia indicates that immune dysfunction in schizophrenia is not just an epiphenomenon, but related to the pathomechanism of the disorder.The study was supported by the Theodore and Vada Stanley Medical Research Institute     

利培酮、奎的平对精神分裂症疗效及与血清细胞因子水平变化的关系

目的 比较利培酮和奎的平对精神分裂症的临床疗效与血清白介素-2(IL-2)、可溶性白介素-2受体(SIL-2R)水平变化的关系。方法将60例精神分裂症患者随机分为利培酮组和奎的平组进行6周治疗，采用PANSS量表评定疗效，同时测定血清IL-2、SIL-2水平。结果 两药疗效相当，其阳性症状的改善与显著下降的IL-2水平相关。结论 利培酮和奎的平对精神分裂症的阳性症状的疗效可能与降低血清IL-2水平有关。     

利培酮和氟哌啶醇对精神分裂症白细胞介素的作用及其与疗效的关系

目的　探讨典型、非典型抗精神病药对精神分裂症白细胞介素 (IL)的影响及其与疗效之间的关系 ,以及免疫状态与精神症状的关系。方法　采用随机、双盲法应用固定剂量的利培酮和氟哌啶醇对 78例慢性精神分裂症进行 12周治疗 ,并在治疗前后评定PANSS量表。以 18例健康人为对照。同时在治疗前后测定血浆IL 2、IL -6和IL -8含量。结果①利培酮和氟哌啶醇治疗均降低精神分裂症过高的IL 2水平 ,两者之间无明显差异。②两种药物对患者过高的IL -6、IL 8水平均无明显影响。③治疗前IL 2、IL 8越低 ,则疗效越好。④治疗后IL 8水平与精神症状、主要是阳性症状有关。结论非典型和典型抗精神病药对精神分裂症免疫应答产生一定程度的抑制作用 ,两者之间无明显差异 ;患者治疗前的免疫水平与疗效之间存在一定的关系     

阿立哌唑与利培酮治疗精神分裂症对照研究

目的：比较阿立哌唑与利培酮对精神分裂症的疗效及安全性。方法：选取70例精神分裂症患者,随机分为阿立哌唑组36例,利培酮组34例,分别给予阿立哌唑和利培酮治疗,疗程8周。在治疗前及治疗1、2、4、6、8周末分别采用阳性与阴性症状量表（PANSS）、治疗中出现的症状量表（TESS）对两组进行评定。并于治疗前、中、后检查催乳素水平。结果：两组治疗后PANSS评分均有显著下降。阿立哌唑组的锥体外系不良反应、体质量增加及月经失调均较利培酮组少而轻,对催乳素水平没有影响。结论：2药对精神分裂症均有较好的疗效,起效快,不良反应小。     

首发精神分裂症患者利培酮治疗前后血浆瘦素和白细胞介素-6的研究

目的探讨精神分裂症患者利培酮治疗前后血浆瘦素和白细胞介素-6(IL6)水平的变化及意义。方法患者组为65例首发的精神分裂症患者,利培酮治疗前和治疗8周后分别测量身高、体重以计算体质量指数,用放射免疫方法检测其空腹血浆瘦素和IL6。选取52名健康人作为对照组进行比较。结果治疗后患者组体质量指数、血浆瘦素水平均明显上升,与治疗前比较差异有显著性(P均小于0.05);患者组血浆IL6水平在治疗前与对照组相比明显增高,治疗后明显下降,与治疗前比较差异有显著性(P均小于0.05);治疗前后血浆瘦素的差值和IL6的差值呈负相关(r=-0.388,P<0.05)。结论首发精神分裂症患者血浆IL6水平高于对照组,服用利培酮治疗容易出现药源性肥胖,增高的IL6水平可能是瘦素抵抗的原因之一;过高的瘦素水平与IL6之间可能存在负反馈。     

利培酮对慢性精神分裂症泌乳素的影响

目的探讨非典型抗精神病药利培酮对泌乳素的影响及其与临床疗效的关系。方法采用固定剂量利培酮（６ｍｇ／ｄ）治疗慢性、男性精神分裂症３０例,疗程１２周;在治疗前后评定ＰＡＮＳＳ量表,并用放射免疫法测查血浆中泌乳素（ＰＲＬ）浓度。以１６例健康人为对照。结果治疗后,患者ＰＡＮＳＳ总分及其分量表均显著降低;治疗前患者ＰＲＬ较对照组显著降低,治疗后显著性增高。治疗前后泌乳素差值与ＰＡＮＳＳ阳性症状分量表减分值、减分率显著相关。结论利培酮对精神分裂症血泌乳素水平有明显影响,而且泌乳素水平与临床疗效相关。     

3种抗精神病药对精神分裂症认知功能的影响

目的:探讨阿立哌唑、利培酮和氯丙嗪对首发精神分裂症患者认知功能的影响。方法:56例首发精神分裂症患者分为阿立哌唑组(n=18)、利培酮组(n=24)和氯丙嗪组(n=14),在治疗前和治疗6周进行阳性与阴性症状量表(PANSS)评分,威斯康星卡片分类测验(WCST)、连线测验(A和B)、韦氏成人智力量表(WAIS)中的数字符号和数字广度(顺、逆)测验等神经心理测验。结果:治疗6周后,3组PANSS评分均明显下降,3组之间差异无显著性。阿立哌唑组和利培酮组各项认知功能指标均有不同程度的改善,而氯丙嗪组只有2项(WCST中持续反应数和数字广度测验)较治疗前显著好转。连线测验B阿立哌唑组显著优于利培酮组,其余各指标两组间差异无显著性。阿立哌唑组除WCST中持续反应数、完成分类数和数字广度测验外,其余各指标均显著优于氯丙嗪组;利培酮组除WCST中持续反应数外,其余各指标均显著优于氯丙嗪组。结论:阿立哌唑和利培酮对首发精神分裂症患者认知功能的改善作用相当,均显著优于氯丙嗪。     

Decreased motor impulsivity following chronic lithium treatment in male rats is associated with reduced levels of pro-inflammatory cytokines in the orbitofrontal cortex

Lithium’s efficacy in reducing both symptom severity in bipolar disorder (BD) and suicide risk across clinical populations may reflect its ability to reduce impulsivity. Changes in immune markers are associated with BD and suicidality yet their exact role in symptom expression remains unknown. Evidence also suggests that lithium may decrease levels of pro-inflammatory cytokines in the periphery and central nervous system, and that such changes are related to its therapeutic efficacy. However, issues of cause and effect are hard to infer from clinical data alone. Here, we investigated the effects of chronic dietary lithium treatment on rats’ performance of the 5-Choice Serial Reaction Time Task (5CSRTT), a well-validated operant behavioural task measuring aspects of impulsivity, attention and motivation. Male Long-Evans rats received a diet supplemented with 0.3% LiCl (n = 13), or the equivalent control diet (n = 16), during behavioural testing. Blood and brain tissue samples were assayed for a wide range of cytokines once any changes in impulsivity became significant. After 12 weeks, chronic lithium treatment reduced levels of motor impulsivity, as indexed by premature responses in the 5CSRTT; measures of sustained attention and motivation were unaffected. Plasma levels of IL-1β, IL-10 and RANTES (CCL-5) were reduced in lithium-treated rats at this time point. IL-1β, IL-6 and RANTES were also reduced selectively within the orbitofrontal cortex of lithium-treated rats, whereas cytokine levels in the medial prefrontal cortex and nucleus accumbens were comparable with control subjects. These results are consistent with the hypothesis that lithium may improve impulse control deficits in clinical populations by minimising the effects of pro-inflammatory signalling on neuronal activity, particularly within the orbitofrontal cortex.     

Risperidone in psychotic combat-related posttraumatic stress disorder: an open trial

RATIONALE: Psychotic symptoms that frequently occur in combat-related posttraumatic stress disorder (PTSD) complicate its pharmacotherapy. We hypothesized that war veterans with psychotic PTSD, resistant to prior antidepressant treatment, would respond well to 6 weeks of treatment with the atypical antipsychotic risperidone, given as a monotherapy. METHOD: Twenty-six male war veterans with psychotic PTSD (DSM-IV) completed the 6-week inpatient treatment with risperidone (2-4 mg/day) during the period from November 1999 through December 2002. The primary outcome measure was change from baseline to endpoint (6 weeks) in Positive and Negative Syndrome Scale (PANSS) total and subscale scores. Secondary outcome measures were changes in PTSD Interview (PTSD-I) and Clinical Global Impressions-Severity of Illness scale (CGI-S) total and subscale scores. Clinical improvement was assessed by CGI-S, CGI-Improvement scale, and Patient Global Impression of Improvement scale, while adverse events were recorded by Drug-Induced Extrapyramidal Symptoms Scale. RESULTS: Treatment with risperidone for either 3 or 6 weeks in an open trial significantly reduced total and subscales scores on the PANSS and on the PTSD-I and CGI-S when compared to baseline scores in patients with psychotic PTSD. CONCLUSION: Our preliminary data from the open trial indicate that risperidone decreased most of the psychotic and PTSD symptoms. Psychotic PTSD patients, unresponsive to antidepressant treatment, improved significantly after treatment for either 3 or 6 weeks with risperidone.     

Interleukin-12 plasma levels in drug-naïve patients with a first episode of psychosis: effects of antipsychotic drugs

An overactivation of the Th1 activity in schizophrenia had been described. Interleukin-12 (IL-12), a proinflammatory cytokine, plays a key role in the regulation of the Th1 response. The aims of this study were to investigate the effect of first and second generation antipsychotic drugs on IL-12 production during the acute phase of the illness and its association with clinical features. Participants comprised 56 drug-na?ve first episode psychotic patients and 28 healthy volunteers. Patients were initially randomly assigned to risperidone (n=16), olanzapine (n=20) or haloperidol (n=20); subject were maintained on the same medication throughout the study. Clinical assessments were conducted at baseline and at 6 weeks. IL-12 plasma levels were assessed at baseline and after 6 weeks of antipsychotic treatment. IL-12 haplotypes were also analysed. Patients showed higher IL-12 plasma levels at baseline compared with controls, and had a significant increase in IL-12 plasma level after 6 weeks of antipsychotic treatment. No significant differences in IL-12 level increase were found among the three antipsychotic treatments. IL-12 plasma levels at week 6 were not significantly associated with the severity of psychopathology at week 6. Thus, patients with a first episode of psychosis have inflammatory-like immunological function during early phases of the illness that it is independent of the antipsychotic treatment used.     

Safety and efficacy of long-acting risperidone in schizophrenia: a 12-week, multicenter, open-label study in stable patients switched from typical and atypical oral antipsychotics

BACKGROUND: The safety and efficacy of the first long-acting injectable atypical antipsychotic, risperidone, were assessed in stable patients with schizophrenia switched from oral antipsychotic medications. METHOD: Data were collected between July 1, 2001, and October 25, 2002. The study population included patients from clinics, hospitals, and physicians' offices. After a 4-week run-in period, symptomatically stable patients with schizophrenia (DSM-IV) who had been taking haloperidol (N = 46), quetiapine (N = 45), or olanzapine (N = 50) received 25 mg of long-acting risperidone. The oral antipsychotics were continued for 3 weeks after the first injection of long-acting risperidone. Injections were administered every 2 weeks at 25 mg up to a maximum dose of 50 mg for 12 weeks in this multicenter, open-label study. RESULTS: Long-acting risperidone was well tolerated. Of the 141 patients who participated in the study, the most frequently reported adverse events were insomnia (16%), headache (15%), psychosis (11%), and agitation (11%). The mean increase in body weight was 0.4 kg. No other clinically relevant laboratory abnormalities or significant electrocardiogram changes were observed during the 12-week treatment. Extrapyramidal Symptom Rating Scale total scores were reduced during treatment with long-acting risperidone. Improvements in symptoms of schizophrenia were observed with long-acting risperidone at week 4 and continued through the 12-week treatment with significant reductions in total Positive and Negative Syndrome Scale (PANSS) scores at week 8 (-2.5, p <.01) and week 12 (-3.9, p <.001). At endpoint, 37% (50/135) of these stable patients were rated as clinically improved (> or = 20% decrease in PANSS total scores). CONCLUSIONS: Switching treatment from oral antipsychotics to long-acting risperidone without an intervening period of oral risperidone was safe and well tolerated. Long-acting risperidone also significantly reduced the severity of symptoms in these stable patients with schizophrenia.     

阿立哌唑、利培酮及氯丙嗪对精神分裂症疗效及认知功能的影响

目的探讨非经典抗精神病药阿立哌唑、利培酮及传统抗精神病药氯丙嗪治疗精神分裂症的疗效及对认知功能的影响。方法将148例符合CCMD-3诊断标准的精神分裂症病人随机分为阿立哌唑组（48例）、利培酮组（52例）和氯丙嗪组（48例），观察12周，分别于治疗前及治疗后4、8、12周采用阳性症状与阴性症状量表（PANSS）、不良反应量表（TESS）评定疗效和不良反应；治疗前及治疗后12周采用韦氏成人记忆测检（WMS）及威斯康星卡片分类测验（WCST）测定。结果与治疗前比较，三组治疗后12周PANSS总分及各因子分显著下降（P〈0．01），但三组之间无显著差异；利培酮、氯丙嗪组的不良反应发生率高于阿立哌唑组（P〈0．05），主要表现为肌强直、震颤等锥体外系等不良反应；阿立哌唑、利培酮组WMS和WCST评分均有显著改善，而氯丙嗪组治疗前后则无差异。结论阿立哌唑、利培酮及氯丙嗪治疗精神分裂症均有效，且疗效相当，阿立哌唑所致锥体外系不良反应较少，阿立哌唑、利培酮对认知功能有改善作用，而氯丙嗪则对认知功能无影响。     

The effect of treatment with risperidone,olanzapine or phenothiazines on cognitive functions in patients with schizophrenia

INTRODUCTION: Theaimofthestudywastocomparetheeffectsofrisperidone, olanzapine and phenothiazines on cognitive functions in schizophrenia during short-term (4 &#45 6 weeks) and long-term (3 &#45 4 months) treatment. METHOD: Seventy patients with schizophrenia were investigated: 30 treated with risperidone, 20 with olanzapine and 20 with phenothiazines, in standard doses. Psychometric measurements were made with the Positive and Negative Syndrome Scale (PANSS), and neuropsychological tests included the Trail Making Test (TMT), the Stroop Test and the Wisconsin Card Sorting Test (WCST). RESULTS: PANSS negative symptoms decreased significantly after risperidone and olanzapine, did not change after short-term, and improved marginally after long-term, phenothiazine treatment. Risperidone treatment resulted in significant amelioration of performance on all neuropsychological tests after both short- and long-term treatment. Olanzapine gave benefit on five out of seven subtests, although in most instances this effect was noted only after long-term treatment. Olanzapine was inferior to risperidone in improving WCST performance. Treatment with phenothiazines brought about improvement on two subtests while the results on three showed significant deterioration. CONCLUSION: The results obtained suggest that novel antipsychotics show differential effect on cognition, with risperidone especially improving working memory; however, their effect on negative symptoms and cognitive functions is better than that of typical neuroleptics.     

Altered Antioxidant Defenses in Drug-Naive First Episode Patients with Schizophrenia Are Associated with Poor Treatment Response to Risperidone: 12-Week Results from a Prospective Longitudinal Study

Abnormal redox regulation is thought to contribute to schizophrenia (SCZ). Accumulating studies have shown that the plasma antioxidant enzyme activity is closely associated with the course and outcome in antipsychotics-naïve first-episode (ANFE) patients with SCZ. The main purpose of this study was to investigate the effect of risperidone on oxidative stress markers in ANFE patients and the relationship between risperidone response and changes in oxidative stress markers. Plasma activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) enzyme, total antioxidant status (TAS), and malondialdehyde (MDA) levels were measured in 354 ANFE patients and 152 healthy controls. The clinical symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS). Patients received risperidone monotherapy for 12 weeks and oxidative stress markers and PANSS were measured at baseline and at follow-up. Compared with healthy controls, the patients exhibited higher activities of SOD, CAT, and TAS levels, but lower MDA levels and GPx activity. A comparison between 168 responders and 50 non-responders at baseline and 12-week follow-up showed that GPx activity decreased in both groups after treatment. Moreover, GPx activity decreased less in responders and was higher in responders than in non-responders at follow-up. These results demonstrate that the redox regulatory system and antioxidant defense enzymes may have predictive value for the response of ANFE patients to risperidone treatment.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13311-021-01036-3.Key Words: Schizophrenia, Oxidative stress, Antioxidant defense system, Clinical response, Risperidone     

注射用利培酮微球与口服利培酮对精神分裂症血浆催乳素及社会功能的影响

目的比较两种不同剂型的利培酮（注射用长效利培酮微球与口服利培酮）对精神分裂症患者血浆催乳素及社会功能的影响。方法 74例口服利培酮≤4mg/d达6周且病情稳定的门诊精神分裂症患者,被随机分为注射长效利培酮微球组（注射组,利培酮剂量每2周为25～50mg）和口服利培酮组（口服组,利培酮剂量≤4mg/d）。于分组前及分组后4周、8周、16周检测患者的血浆催乳素水平,于分组前和分组后8周、16周以个人和社会功能量表（Personal and Social Performance,PSP）评定患者的社会功能,以阳性和阴性症状量表（PANSS）、临床疗效总评量表中的病情严重程度（GGI-SI）及Simpson锥体外系副反应评定量表（SEPS）评定疗效和不良反应。结果注射组37例患者中,有30例（82.1%）完成研究,口服组37例患者中,有32例（85.7%）完成研究,将完成全部研究的患者的资料纳入统计分析。分组前两组的PNASS、CGI-SI及SEPS评分比较均无统计学差异。分组治疗16周后,两组的PANSS评分及CGI-SI评分均下降,但两组间比较无统计学差异;注射组、口服组的SEPS评分的均数（标准差）为3.7（2.5）和5.1（2.8）,（t=2.12,P=0.037）。分组治疗8周后,注射组与口服组的血浆催乳素均数（标准差）分别为48.2（15.7）μg/L及54.2（18.8）μg/L,（t=2.59,P=0.012）,两组的PSP评分的均数（标准差）分别为70.9（9.7）及65.3（11.1）,（t=2.01,P=0.049）;分组16周后,注射组与口服组的血浆催乳素浓度的均数（标准差）分别为31.5（17.1）μg/L及58.5（16.8）μg/L,（t=6.24,P〈0.001）,两组的PSP评分的均数（标准差）分别为79.3（6.0）及66.1（9.6）,（t=6.44,P〈0.001）。两组血浆催乳素水平的差异有统计学意义（F=4.79,P=0.033）,两组PSP分值的差异有统计学意义（F=8.70,P=0.005）。结论与口服利培酮相比,注射长效利培酮微球后患者出现的锥体外系不良反应较轻,高催乳素血症的程度较低,社会功能恢复较好。     

Monocytic, Th1 and th2 cytokine alterations in the pathophysiology of schizophrenia

A growing body of evidence suggests that changes in the serum levels and cellular production of various cytokines are associated with the immunological abnormalities of schizophrenia. Several studies have examined alterations in T helper type 1 (Th1) and T helper type 2 (Th2) cytokines in schizophrenia. We explored monocytic, Th1 and Th2 cytokines in 43 schizophrenia patients and 50 normal controls. The mitogen-induced production of tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6), IL-4, gamma-interferon (IFN-gamma) and IL-2 was measured with enzyme-linked immunosorbent assays before and after antipsychotic treatment. IL-6 and TNF-alpha production by schizophrenic patients was significantly higher than by normal controls, while IL-2, IL-4 and IFN-gamma production was significantly lower in schizophrenic patients. After 6 weeks of antipsychotic treatment, IL-6 and TNF-alpha production was significantly decreased, while IL-4, IFN-gamma and IL-2 productions were not significantly changed. Our results suggest that increased monocytic cytokines and decreased Th1 and Th2 cytokines may be associated with the immunopathogenesis of acute psychotic schizophrenia, and that antipsychotics may play an important role in immune response by decreasing elevated monocytic cytokines.     

奥氮平与利培酮治疗首发精神分裂症对照研究

目的 比较奥氮平与利培酮治疗首发精神分裂症的疗效及不良反应。方法 随机将符合CCMD-2R精神分裂症的诊断标准70例患者进入奥氮平或利培酮组接受治疗,分别在治疗0、1、2、4、6、8周评定PANSS和TESS量表,在0、4、8周检查心脑电图和肝肾功能,在0、8周检查血催乳素和空腹血糖。结果 奥氮平与利培酮疗效相当,奥氮平能迅速减轻精神症状,其产生的不良反应少、严重程度轻,很少引起血催乳素变化;利培酮会显著提高血催乳素水平。结论 奥氮平对首发精神分裂症治疗安全有效。