Vitamin B₁₂ in Association with Antipsychotic Drugs Can Modulate the Expression of Pro-/Anti-Inflammatory Cytokines in Alzheimer Disease Patients

Abstract

Introduction: Patients with Alzheimer disease (AD) suffer from psychotic symptoms including pain. The current antipsychotic drugs confer limited effectiveness, and hence new strategies are being designed to decrease pain in order to increase antipsychological effectiveness. Vitamin B₁₂ is a safe supplementary drug to decrease pain. Additionally, cytokines participate in the pathogenesis of immune-related diseases such as AD. Thus, the main aim of this clinical trial study was to determine the effects of treatment with risperidone and quetiapine, as antipsychotic drugs, with and without vitamin B₁₂ on the psychotic symptoms of AD patients and the expression of IL-6, IL-8, tumor growth factor (TGF)-β, tumor necrosis factor (TNF)-α, and endothelin (ET)-1). Material and Methods: Serum levels of IL-6, IL-8, TGF-β, TNF-α, and ET-1 were evaluated in the following groups: healthy controls, nonpsychotic AD patients, psychotic AD patients, psychotic AD patients under treatment with risperidone, psychotic AD patients under treatment with risperidone plus vitamin B₁₂, psychotic AD patients under treatment with quetiapine, and psychotic AD patients under treatment with quetiapine plus vitamin B₁₂. Results: Treatment with antipsychotic drugs plus vitamin B₁₂ led to a decreased expression of IL-8 and TNF-α and an increased expression of TGF-β. Vitamin B₁₂ in association with quetiapine reduced the pain in psychotic AD patients. Discussion: Proinflammatory cytokines play important roles in the pathogenesis of psychosis in AD patients. Antipsychotic drugs plus vitamin B₁₂ can reduce and induce the expression of proinflammatory and anti-inflammatory cytokines to improve psychotic symptoms in AD patients.

Innate Immunity: A Common Denominator between Neurodegenerative and Neuropsychiatric Diseases

“…Treatment with antipsychotic drugs, such as quetiapine plus vitamin B12, have led to a decreased expression of pro-inflammatory cytokines such as IL-8, TNFα, and TGF-β, which primarily suppress immune response. These cytokines can be produced at higher levels in schizophrenic patients [261].…”

The Influence of Nutritional Factors on Immunological Outcomes

“…Together with B2, vitamin B12 has shown promising results in controlling inflammation-associated disease symptoms. Patients with Alzheimer’s disease who received antipsychotic drugs plus vitamin B12 had decreased expression of the proinflammatory cytokines IL-8 and TNF-α and increased expression of the anti-inflammatory cytokine TGF-β and exhibited milder psychotic symptoms ( 94 ). A prospective clinical trial involving 30 healthy Brazilian adults examined the effect of a daily dose (5 mg) of folic acid on immunity and showed a folate-associated significant reduction in the number and cytotoxicity of NK cells, as well as higher levels of the cytokines IL-8 and TNF-α ( 95 ).…”

Vitamin B12 Levels in Methamphetamine Addicts

“…It was reported that a low B12 level was associated with overexpression of pro-inflammatory cytokines (Politis et al, 2010). Pro-inflammatory cytokines might be involved in the pathophysiology of many psychiatric conditions (Banerjee et al, 2017; Vakilian et al, 2018). (2) Mitochondrial DNA disorders.…”