Muscle Enzyme Release in the Acute Psychoses

Incidence and Risk Factors of Benign Creatine Phosphokinase Elevations in Chronic Psychiatric Patients

“…Moreover, this may be an underestimation since these data were derived from monthly measurement of CPK levels and some CPK elevations might have been overlooked. Although an exact comparison is impossible owing to differences in observation periods and related factors, the incidence of CPK elevation found in this study is high in comparison to 3 of 16 (19%) reported by Meltzer [2], in which CPK levels (normal range, less than 55 U/l) were determined 2 or 3 times each week during hospitalization, and 2 of 42 (5%) reported by Coffey et al [6], in which CPK levels (abnormal range, above 50 U/l) were followed for at most 40 days.…”

Marked Elevations of Serum Creatine Kinase Activity Associated with Antipsychotic Drug Treatment

“…The frequency of monitoring in the other 110 cases was sparse, so it is not possible to rule out asyptomatic, transient SCK increases in these patients. The increases in SCK activity noted here were much greater in magnitude and longer in duration than previously reported in acutely psychotic patients, which usually ranged from 2 to 20 times the upper limit of normal (Meltzer 1968(Meltzer , 1969(Meltzer , 1970(Meltzer , 1971(Meltzer , 1975(Meltzer , 1976aMeltzer and Moline 1970b). Peak levels in the patients studied here ranged from 1,591 to 177,363 IU /L (median, 11,004 IU /L).…”

“…The median increases were approximately 100 times the levels in these subjects at baseline or after recovery. The duration of the increases in the cases reported here once medication was stopped ranged from 4 to 28 days (median, 9 days), which is significantly longer than the 2-to 5-day duration of elevated SCK activity usually present during acute psychosis (Meltzer 1968(Meltzer , 1969(Meltzer , 1970(Meltzer , 1976a. To our knowledge, these increases were not associated with any loss of muscle function, such as weakness, because the amount of CK activity in skeletal muscle is enormously greater than the amount that would have been necessary to produce the increase noted here.…”

“…However, SCK activity was studied five times a week in 318 hospitalized schizophrenic and other psychiatric patients (median duration of hospitalization, 34 days) treated mainly with haloperidol, chlorpromazine, thioridazine, or fluphenazine. Close attention was paid to adventitious causes of SCK increases (Meltzer 1968(Meltzer , 1969(Meltzer , 1970(Meltzer , 1976aCogen et al 1978). SCK levels of the magnitude we note were completely absent in all of these patients (upper limit of normal, 100 IU /L, depending on race and sex).…”

Enzymic, Electrophoretic and Immunoreactive Properties of Labeled MM and BB Isoenzymes of Human Creatine Kinase

“…Contrary to what might be ex pected, MM-CK, rather than BB isoenzyme, has been found elevated in the serum of patients with acute brain diseases (1,4,6,9,12). This paradoxical finding has no clear explanation as yet.…”