The Side Effect of Haloperidol in Schizophrenic Patients: Analysis of Red Blood Cell Distribution Width (RDW) and Mean Platelet Volume (MPV) Values

Abstract

INTRODUCTION: Like the increase of pro-inflammatory cytokines and oxidative stress as schizophrenia pathophysiology, haloperidol also increases RDW and MPV values. Both of these values ​​have been clinicians concern because they are a risk factor for the various type of vascular disease.
 
 OBJECTIVE: This study aims to determine the side effect of haloperidol on RDW and MPV values in schizophrenic patients. 
 
 METHODS: This research method uses observational analytic design with a prospective cohort approach with pre and posts analysis conducted at the Regional Special Hospital of South Sulawesi Province during May - July 2018 in 30 schizophrenic subjects. The subjects were diagnosed as first episode schizophrenia based on ICD 10, blood samples were taken, for RDW and MPV values ​​before and after haloperidol was given at the 4th and 8th weeks.
 
 RESULTS: The results showed that the mean RDW value at the 4th week was higher in 15 mg/day haloperidol group (15.8) compared to 7.5 mg/day haloperidol group (15.3) with p<0.05. Mean RDW value taken at 8th week was higher in 15 mg/day haloperidol group (16.4) compared to 7.5 mg/day haloperidol group (15.6) with p<0.001. Mean MPV value taken at 8th week was higher in 15 mg/day haloperidol group (13.3) compared to 7.5 mg/day haloperidol group (11.6) with p<0.001. 
 
 CONCLUSION: This study showed an increase in the RDW value in schizophrenia subjects prior to the haloperidol administration. RDW ​​and MPV values were higher after haloperidol treatment compares to before haloperidol treatment. The increase of RDW and MPV values tend to be influenced by haloperidol dosage and administration duration.

Sex-dependent effects of long-term clozapine or haloperidol medication on red blood cells and liver iron metabolism in Sprague Dawley rats as a model of metabolic syndrome

“…Moreover, a case report showed that hemoglobin levels were severely reduced under clozapine and that clozapine-induced anemia originates from bone marrow suppression [ 35 ]. The study by Tanra et al [ 36 ] showed an increase in RDW and mean platelet volume (MPV) under haloperidol, again without differentiation by sex. Iron deficiency anemia, the most common form of anemia, shows a hypochromic, microcytic blood count, whereas the rats in our study are normocytic with decreased hemoglobin levels in male rats like most of the clozapine medicated non-smoker patients [ 7 ].…”

Is Red Cell Distribution Width a Reliable Marker for Cardiovascular Diseases? A Narrative Review

“…10 Moreover, any other factor such as toxic substances, chemotherapeutic agents, radiation, and other drugs impacting the bone marrow stem cells' life cycle, may increase the RDW. [11][12][13] Obesity and metabolic syndrome which are well-known causes of chronic lowgrade systemic inflammation are also associated with higher RDW. 14 Apart from abnormal erythropoiesis, any factor causing RBC fragmentation in peripheral blood could raise the RDW.…”