Folic acid, vitamin B12 and homocysteine levels following olanzapine administration in schizophrenia patients

Abstract

Mental illness has reached an alarming proportion over the globe and is increasing day by day. Among them, schizophrenia is one of the commonest psychotic illnesses. Schizophrenia is a disabling mental disorder that causes disruptions in thought processes, perceptions, emotions, and cognitive function, resulting in a clinical phenotype with symptoms such as delusions, hallucinations, negativism, or intellectual and social deterioration. It has a lifetime prevalence of approximately 1% of the world's population. 1 Schizophrenia presumably includes a complex pathophysiology and multifunctioning genes might be involved in its pathophysiology. Non-genetic factors such as ethnicity, drug or alcohol abuse, lifestyle, use of medications, prenatal and neonatal infections, maternal malnutrition, and complications during birth may play an important role in the development of schizophrenia. 2 Several biological studies have suggested that the alteration in the normal metabolic process leading to alteration of the levels of folic acid and vitamin B12, and subsequently increased levels of homocysteine might play an important role in the pathophysiology of schizophrenia. [3][4][5][6] Folic acid and vitamin B12 are important cofactors for the synthesis of purine and thymedine precursors of nucleic acid. 7 The metabolism of some amino acids are e.g., interconversion of serine to glycine and conversion of homocysteine to methionine or cysteine 8 and the synthesis of s-adenosylmethionine (SAM). SAM is the major methyl group donor for the various reactions of methylation, by promoting the conversion of homocysteine into methionine. 8Homocysteine, a sulfur-containing amino acid, is metabolized by remethylation using folate and vitamin B12 as cofactors. Recent several studies have reported that increased plasma homocysteine levels were observed in schizophrenia. It has also been estimated that 5 μmol/ L increases in the plasma homocysteine level may lead to an increased risk of schizophrenia by 70%. 9 Several studies have shown a positive correlation between the homocysteine levels and the severity of negative symptoms of schizophrenia. 10-11 Several drugs may interfere the metabolic pathways of folic acid and vitamin B12, leading to an alteration of the plasma homocysteine levels. However, still, there are some controversial results and a lack of evidence regarding these association.In this study, patients with schizophrenia were studied to determine any alteration in homocysteine, folate, and vitamin B12 levels and their correlation with the second generation antipsychotic drug olanzapine which is commonly used to treat the schizophrenic patients. Assessment of the brief psychiatric rating scale (BPRS) score also acts as an aid to the fulfillment of the | Clinical | Trial | AbstractThe purpose of this study was to assess the levels of folic acid, vitamin B12 and homocysteine in the serum of schizophrenia patients (n=20) and to evaluate the effect of olanzapine on these biomarkers. The blood was also collected from the 10 healthy v...