Debrisoquine 4-hydroxylation and sulphamethazine N-acetylation in patients with schizophrenia and major depression

Debrisoquine 4-hydroxylation and sulphamethazine N -acetylation phenotypes were determined in 115 Czech drug-free in-patients with schizophrenia ( n =64) or major depressive disorder ( n =51). These data were compared with a control group of 321 healthy volunteers from the North-East German area of Greifswald. The distribution of debrisoquine hydroxylator phenotypes was almost identical in patients and healthy controls. Thus, there were 8.7% (95% CI 5.4–12.0%) of poor metabolizers (PM) among patients while 8.7% (95% CI 3.6–13.8%) PM among the control group. The prevalences of PM amongst patients with chronic schizophrenia and major depression were 10.9% (95% CI 4.5–21.3%) and 5.9 % (95% CI 1.24–16.3%), respectively (χ² schizophrenics vs control=0.315, NS; χ² depressive patients vs control=0.450, NS). However, within the group of EM patients there was a significant ( P <0.01) shift towards higher debrisoquine metabolic ratios, reflecting a lower hydroxylation capacity in EM patients compared with EM healthy controls. The proportion of slow acetylators (SA) was 60.0% (95% CI 51.0–68.9%) in the entire group of psychiatric patients and 57.5% (95% CI 52.1–62.9%) in the control group (χ² all patients vs control=0.195, NS). Furthermore, there were no significant differences in the prevalence of the SA phenotype between controls and schizophrenics or patients with major depression. Although the results of this modest study were negative, the presence of subtle differences in the metabolic capacity between psychiatric patients and a healthy population cannot be ruled out.