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Gangopadhyay A, Ibrahim R, Theberge K, May M, Houseknecht KL. Non-alcoholic fatty liver disease (NAFLD) and mental illness: Mechanisms linking mood, metabolism and medicines. Front Neurosci 2022; 16:1042442. [PMID: 36458039 PMCID: PMC9707801 DOI: 10.3389/fnins.2022.1042442] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/21/2022] [Indexed: 09/26/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the world and one of the leading indications for liver transplantation. It is one of the many manifestations of insulin resistance and metabolic syndrome as well as an independent risk factor for cardiovascular disease. There is growing evidence linking the incidence of NAFLD with psychiatric illnesses such as schizophrenia, bipolar disorder and depression mechanistically via genetic, metabolic, inflammatory and environmental factors including smoking and psychiatric medications. Indeed, patients prescribed antipsychotic medications, regardless of diagnosis, have higher incidence of NAFLD than population norms. The mechanistic pharmacology of antipsychotic-associated NAFLD is beginning to emerge. In this review, we aim to discuss the pathophysiology of NAFLD including its risk factors, insulin resistance and systemic inflammation as well as its intersection with psychiatric illnesses.
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Affiliation(s)
| | | | | | | | - Karen L. Houseknecht
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME, United States
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2
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Chen P, Wang D, Xiu M, Chen D, Lackey B, Wu HE, Wang L, Zhang X. Association of Transferrin Gene Polymorphism with Cognitive Deficits and Psychiatric Symptoms in Patients with Chronic Schizophrenia. J Clin Med 2022; 11:jcm11216414. [PMID: 36362642 PMCID: PMC9654946 DOI: 10.3390/jcm11216414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022] Open
Abstract
A large amount of recent literature has focused on impaired iron homeostasis in the pathophysiology of schizophrenia. Specifically, microarray analysis has illustrated associations between the transferrin locus and schizophrenia. To elaborate on the effects of transferrin on schizophrenia and its psychiatric phenotypes, our study aimed to investigate whether transferrin gene polymorphism was correlated with cognitive deficits and clinical symptoms in schizophrenia. We recruited 564 patients with chronic schizophrenia and 422 healthy controls (HCs) in a Han Chinese population, collected phenotypic data, and genotyped the rs3811655 polymorphism of the transferrin gene. Our results showed that the rs3811655 polymorphism was related to cognitive performance in both patients and HCs, as well as negative symptoms in patients (all p < 0.05), and patients carrying at least one G-allele showed worsened cognition/severe negative symptoms (all p < 0.05). Further analyses also found that the rs3811655 polymorphism in combination with cognition may exert small but significant contributions to the negative (β = −0.10, t = −2.48, p < 0.05) or total psychiatric symptoms (β = −0.08, t = −1.92, p < 0.05) in patients. Our findings indicated that the rs3811655 polymorphism may be implicated in the cognitive deficits of schizophrenia and HCs as well as psychiatric symptoms in patients, which suggested the possible iron regulatory mechanism in the pathology of schizophrenia.
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Affiliation(s)
- Pinhong Chen
- Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Meihong Xiu
- Beijing Huilongguan Hospital, Peking University, Beijing 100871, China
| | - Dachun Chen
- Beijing Huilongguan Hospital, Peking University, Beijing 100871, China
| | - Blake Lackey
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Hanjing E. Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Lubin Wang
- Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
- Correspondence:
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3
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Zaks N, Austin C, Arora M, Reichenberg A. Reprint of: Elemental dysregulation in psychotic spectrum disorders: A review and research synthesis. Schizophr Res 2022; 247:33-40. [PMID: 36075821 DOI: 10.1016/j.schres.2022.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/16/2021] [Accepted: 06/19/2021] [Indexed: 10/14/2022]
Abstract
Accumulating evidence from observational studies, genetic research, and animal models suggests a relationship between toxic and nutritive elements and psychotic spectrum disorders (PSD). This review systematically evaluates the current research evidence for two hypotheses: 1) that exposures to abnormal levels of toxic and nutritive elements early in life contributes to the subsequent development of PSD, and 2) that an imbalance of element levels is linked to psychotic illness and clinical severity. We focused on the extant literature on five elements, lead (Pb), copper (Cu), magnesium (Mg), manganese (Mn), and zinc (Zn), because of their previously documented associations with psychiatric problems and the availability of pertinent literature. The review identified 38 studies of which 11 measured Pb, 27 measured Cu, 16 measured Mg, 15 measured Mn, and 25 measured Zn concentrations in PSD patients and controls. A majority of research has been conducted on nutritive element imbalance, and findings are largely mixed. While it is biologically plausible that element dysregulation is an important modifiable risk factor for PSD, more research into exposure in early life is needed to better characterize this relationship.
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Affiliation(s)
- Nina Zaks
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, Mount Sinai, NY, USA
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, Mount Sinai, NY, USA
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine, Mount Sinai, NY, USA; Seaver Center of Research and Treatment, Icahn School of Medicine, Mount Sinai, NY, USA; Friedman Brain Institute, Icahn School of Medicine, Mount Sinai, New York, NY, USA.
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4
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Abulseoud OA, Yehia A, Egol CJ, Nettey VN, Aly M, Qu Y, Skolnik AB, Grill MF, Sen A, Schneekloth TD. Attenuated initial serum ferritin concentration in critically ill coronavirus disease 2019 geriatric patients with comorbid psychiatric conditions. Front Psychiatry 2022; 13:1035986. [PMID: 36440432 PMCID: PMC9681793 DOI: 10.3389/fpsyt.2022.1035986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/20/2022] [Indexed: 11/10/2022] Open
Abstract
We examined the effects of psychiatric comorbidity, sex, and ICU admission on serum ferritin concentration in 628 elderly patients (79.7 ± 8.5 years) with positive SARS-CoV-2 PCR test. Hospitalization was required in 96% of patients and 17% required ICU admission. Patients with COVID-19 and psychiatric comorbidities (n = 212) compared to patients without psychiatric comorbidities (n = 416) had significantly lower ferritin concentration (570.4 ± 900.1 vs. 744.1 ± 965, P = 0.029), a greater incidence of delirium (22.6 vs. 14.4%, P = 0.013) and higher mortality (35.3 vs. 27.6%, P = 0.015). Furthermore, we found significant effects for sex (P = 0.002) and ICU admission (P = 0.007). Among patients without comorbid psychiatric conditions, males had significantly higher ferritin compared to females (1,098.3 ± 78.4 vs. 651.5 ± 94.4, P < 0.001). ICU patients without comorbid psychiatric conditions had significantly higher serum ferritin compared to ICU patients with comorbid psychiatric conditions: (1,126.6 ± 110.7 vs. 668.6 ± 156.5, P < 0.001). Our results suggest that the presence of comorbid psychiatric conditions in elderly patients with COVID-19 is associated with higher rates of delirium and mortality and lower ferritin levels during severe illness. Whether high serum ferritin is protective during severe infection requires further investigation.
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Affiliation(s)
- Osama A Abulseoud
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United States.,Department of Neuroscience, Mayo Clinic Graduate School of Biomedical Sciences, Collaborative Research Building (CRB), Scottsdale, AZ, United States
| | - Asmaa Yehia
- Department of Medical Physiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Claudine J Egol
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Victor N Nettey
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Mohamed Aly
- Department of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Yihuai Qu
- Alix School of Medicine at Mayo Clinic, Phoenix, AZ, United States
| | - Aaron B Skolnik
- Department of Critical Care, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Marie F Grill
- Department of Neurology, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Ayan Sen
- Department of Critical Care, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Terry D Schneekloth
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United States
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5
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Interweaving of Reactive Oxygen Species and Major Neurological and Psychiatric Disorders. ANNALES PHARMACEUTIQUES FRANÇAISES 2021; 80:409-425. [PMID: 34896378 DOI: 10.1016/j.pharma.2021.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 10/27/2021] [Accepted: 11/29/2021] [Indexed: 11/21/2022]
Abstract
Reactive oxygen species are found to be having a wide range of biological effects ranging from regulating functions in normal physiology to alteration and damaging various processes and cell components causing a number of diseases. Mitochondria is an important organelle responsible for energy production and in many signalling mechanisms. The electron transport chain in mitochondria where oxidative phosphorylation takes place is also coupled with the generation of reactive oxygen species (ROS). Changes in normal homeostasis and overproduction of reactive oxygen species by various sources are found to be involved in multiple neurological and major neurodegenerative diseases. This review summarises the role of reactive oxygen species and the mechanism of neuronal loss in major neuronal disorders such as Alzheimer's disease, Parkinson's disease, Huntington's disease, Depression, and Schizophrenia.
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6
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Tolmacheva VA. Tardive dyskinesia. CONSILIUM MEDICUM 2021. [DOI: 10.26442/20751753.2021.11.201155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Tardive dyskinesia is a group of hyperkinetic and hypokinetic movement disorders, following the administration of dopamine receptor-blocking drugs. The severity of these syndromes varies from soft forms to the development of life-degrading situations. Phenomenologically tardive dyskinesia can be represented both in isolation and in various combinations. Recognition of these syndromes early in the development of tardive dyskinesia can optimize therapeutic treatment and reduce the risk of severe complications. As a means of treatment, deutetrabenazine or valbenazine are used as first-line drugs, with resistance to therapy and in severe cases, drugs of other groups are used (amantadine, baclofen, botulinum toxin type A, clonazepam, donepezil, gabapentin, ginkgo biloba, levetiracetam, melatonin, pregabalin, thiamine, verapamil, vitamin B6, vitamin E). Our own experience of 12 patients with tardive dystonia showed the effeciency of local injections of botulinum toxin.
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7
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Elemental dysregulation in psychotic spectrum disorders: A review and research synthesis. Schizophr Res 2021; 233:64-71. [PMID: 34242950 DOI: 10.1016/j.schres.2021.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/16/2021] [Accepted: 06/19/2021] [Indexed: 12/12/2022]
Abstract
Accumulating evidence from observational studies, genetic research, and animal models suggests a relationship between toxic and nutritive elements and psychotic spectrum disorders (PSD). This review systematically evaluates the current research evidence for two hypotheses: 1) that exposures to abnormal levels of toxic and nutritive elements early in life contributes to the subsequent development of PSD, and 2) that an imbalance of element levels is linked to psychotic illness and clinical severity. We focused on the extant literature on five elements, lead (Pb), copper (Cu), magnesium (Mg), manganese (Mn), and zinc (Zn), because of their previously documented associations with psychiatric problems and the availability of pertinent literature. The review identified 38 studies of which 11 measured Pb, 27 measured Cu, 16 measured Mg, 15 measured Mn, and 25 measured Zn concentrations in PSD patients and controls. A majority of research has been conducted on nutritive element imbalance, and findings are largely mixed. While it is biologically plausible that element dysregulation is an important modifiable risk factor for PSD, more research into exposure in early life is needed to better characterize this relationship.
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8
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Baj J, Forma A, Sitarz E, Karakuła K, Flieger W, Sitarz M, Grochowski C, Maciejewski R, Karakula-Juchnowicz H. Beyond the Mind-Serum Trace Element Levels in Schizophrenic Patients: A Systematic Review. Int J Mol Sci 2020; 21:ijms21249566. [PMID: 33334078 PMCID: PMC7765526 DOI: 10.3390/ijms21249566] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/06/2020] [Accepted: 12/12/2020] [Indexed: 12/19/2022] Open
Abstract
The alterations in serum trace element levels are common phenomena observed in patients with different psychiatric conditions such as schizophrenia, autism spectrum disorder, or major depressive disorder. The fluctuations in the trace element concentrations might act as potential diagnostic and prognostic biomarkers of many psychiatric and neurological disorders. This paper aimed to assess the alterations in serum trace element concentrations in patients with a diagnosed schizophrenia. The authors made a systematic review, extracting papers from the PubMed, Web of Science, and Scopus databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Among 5009 articles identified through database searching, 59 of them were assessed for eligibility. Ultimately, 33 articles were included in the qualitative synthesis. This review includes the analysis of serum levels of the following trace elements: iron, nickel, molybdenum, phosphorus, lead, chromium, antimony, uranium, magnesium, aluminum, zinc, copper, selenium, calcium, and manganese. Currently, there is no consistency regarding serum trace element levels in schizophrenic patients. Thus, it cannot be considered as a reliable prognostic or diagnostic marker of schizophrenia. However, it can be assumed that altered concentrations of those elements are crucial regarding the onset and exaggeration of either psychotic or negative symptoms or cognitive dysfunctions.
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Affiliation(s)
- Jacek Baj
- Department of Human Anatomy, Medical University of Lublin, 20-400 Lublin, Poland;
- Correspondence:
| | - Alicja Forma
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Elżbieta Sitarz
- Chair and 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Gluska Street 1, 20-439 Lublin, Poland; (E.S.); (K.K.); (H.K.-J.)
| | - Kaja Karakuła
- Chair and 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Gluska Street 1, 20-439 Lublin, Poland; (E.S.); (K.K.); (H.K.-J.)
| | - Wojciech Flieger
- Faculty of Medicine, Medical University of Lublin, Aleje Racławickie 1, 20-059 Lublin, Poland;
| | - Monika Sitarz
- Department of Conservative Dentistry with Endodontics, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Cezary Grochowski
- Laboratory of Virtual Man, Chair of Anatomy, Medical University of Lublin, 20-400 Lublin, Poland;
| | - Ryszard Maciejewski
- Department of Human Anatomy, Medical University of Lublin, 20-400 Lublin, Poland;
| | - Hanna Karakula-Juchnowicz
- Chair and 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Gluska Street 1, 20-439 Lublin, Poland; (E.S.); (K.K.); (H.K.-J.)
- Department of Clinical Neuropsychiatry, Medical University of Lublin, Gluska Street 1, 20-439 Lublin, Poland
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9
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Iron homeostasis alterations and risk for akathisia in patients treated with antipsychotics: A systematic review and meta-analysis of cross-sectional studies. Eur Neuropsychopharmacol 2020; 35:1-11. [PMID: 32444336 DOI: 10.1016/j.euroneuro.2020.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 03/22/2020] [Accepted: 04/09/2020] [Indexed: 11/22/2022]
Abstract
Iron homeostasis may be implicated in the pathophysiology of antipsychotic-related akathisia. We performed a systematic review in six databases from database inception until 03/2020, conducting a meta-analysis of studies investigating iron metabolism in antipsychotic-treated patients with versus without akathisia. Using a fixed- and a random-effects model, standardized mean difference (SMD) was estimated for levels of iron, ferritin, transferrin and total iron-binding capacity. Meta-regression analyses included sex, age, illness duration and antipsychotic treatment and dose. Subgroup analyses included chronic vs. acute akathisia and different diagnoses. Study quality was assessed using the Newcastle-Ottawa scale. In 10 studies (n = 395), compared to non-akathisia patients (n = 213), iron levels were lower in patients with akathisia (n = 182; fixed-effect model: SMD=-0.49, 95%CI=-0.28,-0.70, p<0.001; random-effects model: SMD=-0.55, 95%CI=-0.14,-0.96, p = 0.008). For secondary outcomes, differences were significant regarding lower ferritin levels in patients with akathisia in the fixed-effect model (SMD=-0.32, 95%CI=-0.08,-0.55, p = 0.007), but not in the random-effects model (SMD=-0.29, 95%CI=0.20,-0.79, p = 0.24). None of the moderators/mediators had a significant effect on the group difference of iron levels. Subgroup analyses reported lower iron levels in both patients with chronic and acute akathisia vs. patients without. Iron levels for schizophrenia patients were lower in the fixed-effect model (SMD=-0.55, 95%CI=-0.23, -0.86, p<0.001), while a trend was observed in the random-effects model (SMD=-0.52, 95%CI=-0.07, -1.12, p = 0.08). The studies' quality was overall poor, with one exception. This meta-analysis suggests lower iron levels in akathisia patients, while ferritin differences were significant only in the fixed-effect model. Further data are required to promote the understanding of related pathways.
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Musco S, McAllister V, Caudle I. Dopamine-receptor blocking agent-associated akathisia: a summary of current understanding and proposal for a rational approach to treatment. Ther Adv Psychopharmacol 2020; 10:2045125320937575. [PMID: 32922732 PMCID: PMC7457694 DOI: 10.1177/2045125320937575] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 06/02/2020] [Indexed: 12/17/2022] Open
Abstract
Dopamine-receptor blocking agent-associated akathisia (DRBA-A) is an adverse effect that can significantly limit the use of these important medications for the treatment of a variety of psychiatric diseases, yet there is no unifying theory regarding its pathophysiology. This knowledge gap limits clinicians' ability to effectively manage DRBA-A and mitigate negative outcomes in an already vulnerable patient population. Based on a review of the current literature on the subject, it is hypothesized that dopaminergic and noradrenergic signaling is perturbed in DRBA-A. Accordingly, it is proposed that the optimal agent to manage this extrapyramidal symptom should increase dopamine signaling in the affected areas of the brain and counteract compensatory noradrenergic signaling via antagonism of adrenergic or serotonergic receptors.
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Affiliation(s)
- Shaina Musco
- Department of Clinical Sciences, High Point University Fred Wilson School of Pharmacy, One University Parkway, High Point, NC 27262, USA
| | - Vivian McAllister
- High Point University David R. Hayworth College of Arts and Sciences, One University Parkway, High Point, NC, USA
| | - Ian Caudle
- High Point University Fred Wilson School of Pharmacy, One University Parkway, High Point, NC, USA
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Saghazadeh A, Mahmoudi M, Shahrokhi S, Mojarrad M, Dastmardi M, Mirbeyk M, Rezaei N. Trace elements in schizophrenia: a systematic review and meta-analysis of 39 studies (N = 5151 participants). Nutr Rev 2019; 78:278-303. [DOI: 10.1093/nutrit/nuz059] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 02/14/2019] [Accepted: 06/15/2019] [Indexed: 01/11/2023] Open
Abstract
Abstract
Context
The pathogenesis of schizophrenia appears to be multifaceted.
Objective
The aim of this meta-analysis of studies that investigated blood and hair concentrations of trace elements in people diagnosed with schizophrenia was to determine whether levels of trace elements in patients with schizophrenia differ from those in healthy individuals.
Data Sources
The PubMed, Scopus, and Web of Science databases were searched to January 2018.
Study Selection
Studies that compared concentrations of trace elements in patients with schizophrenia with those in healthy controls, in patients with schizophrenia under different treatment regimens, or in patients with schizophrenia at different stages of disease were included.
Data Extraction
Data on study and sample characteristics and measures of trace elements were extracted.
Results
Thirty-nine studies with a total of 5151 participants were included. Meta-analysis of combined plasma and serum data showed higher levels of copper, lower levels of iron, and lower levels of zinc among patients with schizophrenia vs controls without schizophrenia. Subgroup analyses confirmed the following: higher levels of copper in plasma, in users of typical antipsychotic drugs, and in males; lower levels of zinc in serum, in patients in Asia, in drug-naive/drug-free patients, and in inpatients; lower levels of iron in serum, in patients in Asia, in drug-naive/drug-free patients, in patients on antipsychotic drugs, in inpatients, in patients with acute or newly diagnosed schizophrenia, in patients with chronic or previously diagnosed schizophrenia, and in males; and lower levels of manganese in plasma and in patients with chronic or previously diagnosed schizophrenia.
Conclusions
This meta-analysis provides evidence of an excess of copper, along with deficiencies of zinc, iron, and manganese, in patients with schizophrenia.
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Affiliation(s)
- Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- MetaCognition Interest Group, Universal Scientific Education and Research Network, Tehran, Iran
| | - Maryam Mahmoudi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Pediatric Gastroenterology and Hepatology Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Dietitians and Nutrition Experts Team, Universal Scientific Education and Research Network, Tehran, Iran
| | - Shayan Shahrokhi
- NeuroImmunology Research Association, Universal Scientific Education and Research Network, Tehran, Iran
| | - Maryam Mojarrad
- NeuroImmunology Research Association, Universal Scientific Education and Research Network, Tehran, Iran
| | - Maedeh Dastmardi
- NeuroImmunology Research Association, Universal Scientific Education and Research Network, Tehran, Iran
| | - Mona Mirbeyk
- NeuroImmunology Research Association, Universal Scientific Education and Research Network, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Molecular Immunology Research Center, Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-analysis Expert Group, Universal Scientific Education and Research Network, Boston, Massachusetts, USA
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du Plessis T, Moxley K, Lachman A. Prevalence of iron deficiency in a South African adolescent inpatient psychiatric population: Rates, risk factors and recommendations. S Afr J Psychiatr 2019; 25:1347. [PMID: 31404366 PMCID: PMC6681468 DOI: 10.4102/sajpsychiatry.v25i0.1347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 05/06/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Severe iron deficiency is associated with anaemia, but iron deficiency with normal haemoglobin (Hb) may also affect morbidity and quality of life and contribute to psychiatric illness onset and severity. Psychiatric presentations in adolescence are often indicative of serious long-term morbidity, and addressing contributing health risk factors, such as iron deficiency, is important. OBJECTIVES To determine rates of iron deficiency in a South African inpatient adolescent psychiatric population and possible associations between psychiatric diagnosis and iron deficiency risk factors. METHODS We conducted a retrospective chart review of all adolescent patients (13-18 years old) who were admitted to the Adolescent Psychiatric Inpatient Unit at Tygerburg Hospital (Cape Town, South Africa) during 2016. Patient records were limited to those with haemoglobin and ferritin levels available, as well as a psychiatric disorder diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders. The final sample consisted of 93 patients. RESULTS Of all participants, 7.6% were anaemic, while 22.6% were iron deficient. We found 29% of our population to have anaemia in the absence of iron deficiency. Gender was the only statistically significant correlate, with adolescent females at particular risk of compromised iron status as indicated by a low ferritin level (45% of female sample). CONCLUSION Iron deficiency rates remain a relevant health concern, and testing Hb alone is inadequate to assess iron status in this population. Ferritin is a necessary additional parameter and should be included in the usual medical workup.
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Affiliation(s)
- Theonie du Plessis
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Karis Moxley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anusha Lachman
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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13
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Yoshimura B, Sato K, Sakamoto S, Tsukahara M, Yoshimura Y, So R. Incidence and predictors of acute akathisia in severely ill patients with first-episode schizophrenia treated with aripiprazole or risperidone: secondary analysis of an observational study. Psychopharmacology (Berl) 2019; 236:723-730. [PMID: 30443794 DOI: 10.1007/s00213-018-5101-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/31/2018] [Indexed: 11/27/2022]
Abstract
RATIONALE In the antipsychotic treatment of schizophrenia with little medication history, especially in drug-naïve cases, predictors of side effects are important. However, predictors of antipsychotic-induced akathisia remain unclear. OBJECTIVES This study aimed to investigate the incidence and predictors of acute akathisia in severely ill patients with first-episode schizophrenia spectrum disorders (FES). METHODS This is a secondary analysis of our retrospective observational study. Data were obtained from 129 consecutive patients with FES involuntarily hospitalized in a tertiary psychiatric public hospital and treated with aripiprazole or risperidone. The primary outcome was the presence of acute akathisia during the first 1 month. A Cox proportional hazard model was used to examine significant predictors of the onset of akathisia. RESULTS Acute akathisia was diagnosed in 54 patients (42%). Neither antipsychotics (aripiprazole or risperidone), duration of untreated psychosis, iron deficiency, sex, age nor baseline symptomatic severity was identified as an independent predictor of akathisia. Rapid risperidone initiation significantly increased the onset of akathisia (adjusted hazard ratio [HR], 6.47; 95%; 95% confidence interval [CI], 1.94-21.65; p = 0.002), but rapid aripiprazole initiation did not (adjusted HR, 1.08; 95% CI, 0.50-2.31; p = 0.84). A significant interaction was found between rapid antipsychotic initiation and the risk of akathisia with aripiprazole versus risperidone (p = 0.027). CONCLUSIONS Severely ill patients with FES initiating aripiprazole or risperidone could have a high risk for akathisia. Rapid risperidone initiation should be avoided because of the risk for akathisia, and careful monitoring of akathisia may be necessary for all patients initiating aripiprazole.
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Affiliation(s)
- Bunta Yoshimura
- Department of Psychiatry, Okayama Psychiatric Medical Center, 3-16 Shikatahonmachi, Kita-ku, Okayama City, 700-0915, Japan
| | - Kojiro Sato
- Department of Psychiatry, Okayama Psychiatric Medical Center, 3-16 Shikatahonmachi, Kita-ku, Okayama City, 700-0915, Japan
| | - Shinji Sakamoto
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masaru Tsukahara
- Department of Psychiatry, Okayama Psychiatric Medical Center, 3-16 Shikatahonmachi, Kita-ku, Okayama City, 700-0915, Japan
| | | | - Ryuhei So
- Department of Psychiatry, Okayama Psychiatric Medical Center, 3-16 Shikatahonmachi, Kita-ku, Okayama City, 700-0915, Japan.
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Kim SW, Stewart R, Park WY, Jhon M, Lee JY, Kim SY, Kim JM, Amminger P, Chung YC, Yoon JS. Latent Iron Deficiency as a Marker of Negative Symptoms in Patients with First-Episode Schizophrenia Spectrum Disorder. Nutrients 2018; 10:nu10111707. [PMID: 30412998 PMCID: PMC6266210 DOI: 10.3390/nu10111707] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/02/2018] [Accepted: 11/05/2018] [Indexed: 12/21/2022] Open
Abstract
Iron deficiency may alter dopaminergic transmission in the brain. This study investigated whether iron metabolism is associated with negative symptoms in patients with first-episode psychosis. The study enrolled 121 patients with first-episode schizophrenia spectrum disorder, whose duration of treatment was 2 months or less. Negative symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) and Clinician-Rated Dimensions of Psychosis Symptom Severity (Dimensional) scale of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Prominent negative symptoms were defined as moderate or severe negative symptoms on the Dimensional scale of the DSM-5. Iron deficiency was defined as a serum ferritin ≤ 20 ng/mL. Patients with iron deficiency were significantly more likely to have prominent negative symptoms (45.2 vs. 22.2%; p = 0.014) and a higher PANSS negative symptoms score (p = 0.046) than those with normal ferritin levels. Patients with prominent negative symptoms had significantly lower ferritin levels (p = 0.025). The significance of these results remained after controlling for the duration of illness and other confounding variables. Our finding of an independent association between iron deficiency and negative symptoms in patients at the very early stage of illness implies that iron dysregulation has an effect on negative symptoms in patients with schizophrenia. The possibility of therapeutic intervention with iron should be further investigated.
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Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju 61469, Korea.
- Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju 61220, Korea.
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
- South London and Maudsley NHS Foundation Trust, London SE5 8AF, UK.
| | - Woo-Young Park
- Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju 61220, Korea.
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju 61469, Korea.
- Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju 61220, Korea.
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju 61469, Korea.
- Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju 61220, Korea.
| | - Seon-Young Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju 61469, Korea.
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju 61469, Korea.
| | - Paul Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia.
| | - Young-Chul Chung
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju 54907, Korea.
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju 61469, Korea.
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Shahidi G, Rohani M, Munhoz RP, Akhoundi FH. Tardive Akathisia with Asymmetric and Upper-body Presentation: Report of Two Cases and Literature Review. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2018; 8:563. [PMID: 29971200 PMCID: PMC6026282 DOI: 10.7916/d8224b00] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 04/30/2018] [Indexed: 12/01/2022]
Abstract
Background Akathisia is an inner urge to move a body area with an objective motor component of restlessness. Tardive akathisia (TA) is usually bilateral with a predominant lower-body presentation. We report two patients with an asymmetrical predominantly upper-body involvement. Case Report Two young men with history of psychiatric problems and neuroleptic use revealed atypical TA, characterized by asymmetrical and predominantly upper-body involvement. Their main manifestations were rubbing the face, mostly with one hand, accompanied by an inner sensation of restlessness. Discussion Our patients are proof that TA can present with asymmetrical and upper-body involvement even with normal brain imaging.
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Affiliation(s)
- Gholamali Shahidi
- Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rohani
- Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Renato Puppi Munhoz
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Fahimeh H Akhoundi
- Department of Neurology, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
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Chen X, Li Y, Zhang T, Yao Y, Shen C, Xue Y. Association of Serum Trace Elements with Schizophrenia and Effects of Antipsychotic Treatment. Biol Trace Elem Res 2018; 181:22-30. [PMID: 28470477 DOI: 10.1007/s12011-017-1039-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/25/2017] [Indexed: 02/01/2023]
Abstract
Variation of serum trace elements was previously reported in schizophrenia (SZ) patients; however, whether such variation is resulted from the antipsychotic treatment remains obscure. A case control study consist of 165 SZ inpatients and 614 healthy controls measured serum magnesium (Mg), Copper (Cu), calcium (Ca), phosphorus (Phos), iron (Fe), and zinc (Zn) to investigate the relationship of trace elements and SZ. The SZ patients were further followed up (average 3.8 weeks) to evaluate the effects of antipsychotic treatment on the trace element concentrations using repeated measures ANOVA analysis. The results showed that higher concentrations of Mg and Phos and lower concentrations of Ca, Fe, and Zn were significant in SZ patients than that of controls (P < 0.01). The age was positively correlated with Fe and Cu, and negatively correlated with Ca, Phos, and Zn in controls (P < 0.05). Fe in male SZ patients was significantly higher than in female (P < 0.001), as well as in paranoid SZ and acute SZ (P < 0.05). Phos significantly increased after risperidone, clozapine, and aripiprazole treatment (P < 0.05), while Cu was decreased after clozapine and aripiprazole treatment. Zn significantly decreased particularly in mixed type SZ, acute SZ, and schizotypal SZ after antipsychotic treatment. These results suggested that higher concentration of Phos and lower concentration of Fe and Zn have important implications for the risk of SZ and the antipsychotic treatment is likely to result in the decreased Fe and increased Phos in the clinical subtypes of SZ.
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Affiliation(s)
- Xuefei Chen
- Department of Medical Laboratory, Huaian Third Hospital, 272 Huaihai West Road, Huaian, 223001, People's Republic of China
| | - Yinghui Li
- Department of Medical Laboratory, Huaian Third Hospital, 272 Huaihai West Road, Huaian, 223001, People's Republic of China
| | - Ting Zhang
- School of Public Health, Wannan Medical College, Wuhu, 241001, China
- Department of Epidemiology, School of Public Health, Nanjing Medical University, No. 101 Longmian Avenue, Jiangning District, Nanjing, 211166, China
| | - Yingshui Yao
- School of Public Health, Wannan Medical College, Wuhu, 241001, China
| | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, No. 101 Longmian Avenue, Jiangning District, Nanjing, 211166, China.
| | - Yong Xue
- Department of Medical Laboratory, Huaian Third Hospital, 272 Huaihai West Road, Huaian, 223001, People's Republic of China.
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Ferrosenescence: The iron age of neurodegeneration? Mech Ageing Dev 2017; 174:63-75. [PMID: 29180225 DOI: 10.1016/j.mad.2017.11.012] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/13/2017] [Accepted: 11/15/2017] [Indexed: 12/15/2022]
Abstract
Aging has been associated with iron retention in many cell types, including the neurons, promoting neurodegeneration by ferroptosis. Excess intracellular iron accelerates aging by damaging the DNA and blocking genomic repair systems, a process we define as ferrosenescence. Novel neuroimaging and proteomic techniques have pinpointed indicators of both iron retention and ferrosenescence, allowing for their early correction, potentially bringing prevention of neurodegenerative disorders within reach. In this review, we take a closer look at the early markers of iron dyshomeostasis in neurodegenerative disorders, focusing on preventive strategies based on nutritional and microbiome manipulations.
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Incidence and risk factors of acute akathisia in 493 individuals with first episode non-affective psychosis: a 6-week randomised study of antipsychotic treatment. Psychopharmacology (Berl) 2017; 234:2563-2570. [PMID: 28567698 DOI: 10.1007/s00213-017-4646-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/11/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Acute akathisia is a neuropsychiatric syndrome with a negative effect on illness outcome. Its incidence in patients treated with antipsychotics has shown to be highly variable across studies. OBJECTIVES Our goals were to investigate prevalence, risk factors for the development of acute akathisia, and differences in incidence between antipsychotics in a sample of 493 first episode non-affective psychosis patients. METHODS This is a pooled analysis of three prospective, randomized, flexible-dose, and open-label clinical trials. Patients were randomized assigned to different arms of treatment (haloperidol, quetiapine, olanzapine, ziprasidone, risperidone, or aripiprazole). Akathisia was determined using the Barnes Akathisia Scale at 6 weeks after antipsychotic initialization. Univariate analyses were performed to identify demographic, biochemical, substance use, clinical, and treatment-related predictors of acute akathisia. Considering these results, a predictive model based of a subsample of 132 patients was constructed with akathisia as the dependent variable. RESULTS The overall incidence of akathisia was 19.5%. No differences in demographic, biochemical, substance use, and clinical variables were found. Significant incidence differences between antipsychotics were observed (Χ 2 = 68.21, p = 0.000): haloperidol (57%), risperidone (20%), aripiprazole (18.2%), ziprasidone (17.2%), olanzapine (3.6%), and quetiapine (3.5%). The predictive model showed that the type of antipsychotic (OR = 21.3, p = 0.000), need for hospitalization (OR = 2.6, p = 0.05), and BPRS total score at baseline (OR = 1.05, p = 0.03) may help to predict akathisia emergence. CONCLUSIONS Among second generation antipsychotics, only olanzapine and quetiapine should be considered as akathisia-sparing drugs. The type of antipsychotic, having been hospitalized, and a more severe symptomatology at intake seem to predict the development of acute akathisia.
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Abstract
Drug-induced movement disorders (DIMDs) pose a significant burden to patients, often resulting in nonadherence, disease relapse, and decreased quality of life. Dopamine-receptor blocking agents such as conventional antipsychotics (eg, haloperidol and chlorpromazine) and antiemetics (eg, metoclopramide and prochlorperazine) are most commonly implicated. DIMDs can be categorized by the onset of symptoms: acute reactions occurring hours to days after exposure, subacute DIMDs appearing within weeks, and tardive occurring months to years after drug exposure. The DIMDs of akathisia, tardive dyskinesia, dystonia, and parkinsonism are reviewed. Their epidemiology, mechanism, clinical presentation and differential diagnosis, risk factors, morbidity and mortality, and prevention and management are discussed. For many of these disorders, treatment inconsistently provides benefit, and therefore, primary prevention is essential. Clinicians and other healthcare professionals play a key role in the identification of patients with DIMDs, or those at risk, and in implementing prevention and treatment plans.
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Affiliation(s)
- Katherine L. Claxton
- Aurora Sinai Medical Center, Department of Pharmacy, 945 N State St, Milwaukee, WI 53233
| | - Jack J. Chen
- Schools of Medicine and Pharmacy, Loma Linda University, 11262 Campus St, West Hall, Loma Linda, CA 92350,
| | - David M. Swope
- Department of Neurology and School of Medicine, Loma Linda University, Loma Linda, CA 92350
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20
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Calarge CA, Murry DJ, Ziegler EE, Arnold LE. Serum Ferritin, Weight Gain, Disruptive Behavior, and Extrapyramidal Symptoms in Risperidone-Treated Youth. J Child Adolesc Psychopharmacol 2016; 26:471-7. [PMID: 26894929 PMCID: PMC4931353 DOI: 10.1089/cap.2015.0194] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Iron deficiency disrupts dopaminergic signaling in rodents, resulting in cognitive deficits that may be reversed with psychostimulants. In humans, iron deficiency with or without anemia has similarly been found to cause neuropsychological and behavioral impairments. However, the clinical effects of low body iron stores in antipsychotic-treated children have not been examined. METHODS Medically healthy, 5- to 17-year-old boys treated with risperidone for at least 1 year were enrolled between February 2009 and November 2013 in a multiphase study, examining the skeletal effects of calcium and vitamin D supplementation in risperidone-induced hyperprolactinemia. Anthropometric measures were collected and medical and pharmacy records were reviewed to obtain treatment history. Psychiatric diagnoses were based on clinical interviews, structured interviews, rating scales, and a review of their medical records. Extrapyramidal symptoms were assessed, and a food frequency questionnaire was completed in a subsample. Laboratory tests, including ferritin concentration (a marker of body iron status), were obtained upon study entry. RESULTS A total of 114 participants (mean age: 11.0 ± 2.6 years) were included, the vast majority (>90%) having attention-deficit/hyperactivity disorder and/or disruptive behavior disorder. They had taken risperidone for an average 3.1 ± 2.0 years. Their serum ferritin concentration was 37.3 ± 25.6 μg/L with 21% of the sample having a level <20 μg/L, despite appropriate daily dietary iron intake. Ferritin concentration was inversely associated with weight gain following risperidone treatment onset but was not significantly associated with prolactin. After adjusting for the weight-adjusted dose of psychostimulants and risperidone and the daily dose of selective serotonin reuptake inhibitors, ferritin was inversely associated with the severity of disruptive behavior and positively associated (albeit marginally) with prosocial behavior. No association was found between ferritin concentration and extrapyramidal symptoms. CONCLUSIONS Body iron stores are inversely related to risperidone-induced weight gain, even after extended treatment and despite adequate iron intake. Low iron stores are associated with poorer treatment response. Future research should examine iron absorption during antipsychotic treatment and whether repleting iron stores would facilitate clinical response.
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Affiliation(s)
- Chadi A. Calarge
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Daryl J. Murry
- College of Pharmacy, The University of Iowa, Iowa City, Iowa
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Liu T, Lu QB, Yan L, Guo J, Feng F, Qiu J, Wang J. Comparative Study on Serum Levels of 10 Trace Elements in Schizophrenia. PLoS One 2015; 10:e0133622. [PMID: 26186003 PMCID: PMC4505857 DOI: 10.1371/journal.pone.0133622] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 06/30/2015] [Indexed: 01/03/2023] Open
Abstract
The etiology and pathophysiology of schizophrenia remain obscure. This study explored the associations between schizophrenia risk and serum levels of 10 trace elements. A 1:1 matched case-control study was conducted and matched by age and sex. Blood samples were collected to determine the concentrations of nickel, molybdenum, arsenic, aluminum, chromium, manganese, selenium, copper, iron and zinc by an inductively coupled plasma-mass spectrometry. The conditional logistic regression model was used to analyze the associations between trace elements and schizophrenia risk. Totally 114 schizophrenia patients and 114 healthy controls were recruited in the study. The multivariate analysis demonstrated that copper≤0.97 μg/mL, selenium≤72 ng/mL and manganese>3.95 ng/mL were associated with an increased risk of schizophrenia. The study showed that lower levels of selenium, copper and higher levels of manganese were found in schizophrenia patients compared with healthy controls.
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Affiliation(s)
- Tiebing Liu
- School of Public Health, Peking University, Beijing, People’s Republic of China
- Civil Aviation Medicine Center, Civil Aviation Administration of China, Beijing, People’s Republic of China
| | - Qing-Bin Lu
- School of Public Health, Peking University, Beijing, People’s Republic of China
| | - Lailai Yan
- School of Public Health, Peking University, Beijing, People’s Republic of China
| | - Jing Guo
- Department of Clinical Laboratory, PLA 261st Hospital, Beijing, People’s Republic of China
| | - Fangbo Feng
- Department of Clinical Laboratory, PLA 261st Hospital, Beijing, People’s Republic of China
| | - Jinyun Qiu
- Department of Clinical Laboratory, PLA 261st Hospital, Beijing, People’s Republic of China
| | - Jingyu Wang
- School of Public Health, Peking University, Beijing, People’s Republic of China
- * E-mail:
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Chiarani F, Tramontina JF, Ceresér KM, Kunz M, Paim L, Vargas CR, Sitta A, Machado SP, Wyse ATDS, Kapczinski FP. Homocysteine and other markers of cardiovascular risk during a manic episode in patients with bipolar disorder. BRAZILIAN JOURNAL OF PSYCHIATRY 2013; 35:157-60. [DOI: 10.1590/1516-4446-2012-0797] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 05/14/2012] [Indexed: 11/22/2022]
Affiliation(s)
- Fábria Chiarani
- Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
| | | | | | - Maurício Kunz
- Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
| | - Leonardo Paim
- Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | | | | | | | | | - Flávio Pereira Kapczinski
- Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil; UFRGS, Brazil; UFRGS, Brazil
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Bitanihirwe BKY, Woo TUW. Oxidative stress in schizophrenia: an integrated approach. Neurosci Biobehav Rev 2010; 35:878-93. [PMID: 20974172 DOI: 10.1016/j.neubiorev.2010.10.008] [Citation(s) in RCA: 311] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Revised: 09/18/2010] [Accepted: 10/17/2010] [Indexed: 01/17/2023]
Abstract
Oxidative stress has been suggested to contribute to the pathophysiology of schizophrenia. In particular, oxidative damage to lipids, proteins, and DNA as observed in schizophrenia is known to impair cell viability and function, which may subsequently account for the deteriorating course of the illness. Currently available evidence points towards an alteration in the activities of enzymatic and nonenzymatic antioxidant systems in schizophrenia. In fact, experimental models have demonstrated that oxidative stress induces behavioral and molecular anomalies strikingly similar to those observed in schizophrenia. These findings suggest that oxidative stress is intimately linked to a variety of pathophysiological processes, such as inflammation, oligodendrocyte abnormalities, mitochondrial dysfunction, hypoactive N-methyl-d-aspartate receptors and the impairment of fast-spiking gamma-aminobutyric acid interneurons. Such self-sustaining mechanisms may progressively worsen producing the functional and structural consequences associated with schizophrenia. Recent clinical studies have shown antioxidant treatment to be effective in ameliorating schizophrenic symptoms. Hence, identifying viable therapeutic strategies to tackle oxidative stress and the resulting physiological disturbances provide an exciting opportunity for the treatment and ultimately prevention of schizophrenia.
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Affiliation(s)
- Byron K Y Bitanihirwe
- Laboratory of Behavioural Neurobiology, Swiss Federal Institute of Technology, Zurich, Schorenstrasse 16, Schwerzenbach CH 8603, Switzerland.
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García-Borreguero D, Williams AM. Dopaminergic augmentation of restless legs syndrome. Sleep Med Rev 2010; 14:339-46. [PMID: 20219397 DOI: 10.1016/j.smrv.2009.11.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 11/29/2009] [Accepted: 11/30/2009] [Indexed: 11/24/2022]
Abstract
Dopaminergic agents are the first-line treatment of restless legs syndrome (RLS), and have been used for the treatment of this disorder since the 1980s. The major issue with this class of drugs is augmentation of RLS symptoms during treatment. The first report of augmentation found an occurrence among 73% of patients treated with levodopa. Subsequent studies have reported somewhat lower incidences, but augmentation remains a clinically significant issue with all dopaminergic agents. It was not until 2007 that an operational, empirical definition of augmentation (Max Planck Institute Criteria) was made. This late development and the fact that studies have not been specifically designed to assess augmentation, have made it particularly difficult to compare the incidence rates for the different RLS treatments. As the primary neural and molecular substrates underlying idiopathic RLS are not known, the pathophysiology of augmentation remains unclear, however there are several hypotheses that concern the role of dopaminergic hyperstimulation, of iron deficiency, the genetic component, the effect of a reduction in responsiveness of tubero-infundibular dopamine receptors, and the role of chronobiotic mechanisms. RLS is treated by maintaining low doses of dopaminergic agents and ensuring iron sufficiency. Non-dopaminergics and opiates can be used when patients experience augmentation with more than one dopaminergic agent.
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Detweiler MB, Kalafat N, Kim KY. Drug-Induced Movement Disorders in Older Adults: An Overview for Clinical Practitioners. ACTA ACUST UNITED AC 2009; 22:149-65. [PMID: 17367248 DOI: 10.4140/tcp.n.2007.149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To provide an overview of some of the most common drug-induced movement disorders (DIMD) seen in the elderly by the primary care clinician. The epidemiology, clinical presentation, differential diagnosis, treatment, risk factors, and preventive measures are presented for each DIMD. DATA SOURCES Medical literature and research article search utilizing PubMed (National Library of Medicine), Psych INFO (American Psychological Association), CINAHL Database (CINAHL Information Systems), the Library of Congress Catalogue, and the Internet. STUDY SELECTION Reviews and articles from 1954 to 2005 concerning various movement disorders associated with medication in older adults. DATA EXTRACTIONS: Data on movement disorders associated with medications ranging from possible or controversial to well-established. DATA SYNTHESIS With the aging of populations in the United States and other countries, the use of medications with potential risk of precipitating movement disorders is increasing. The majority of these iatrogenic problems will be first seen in the geriatric patient in various clinical settings, typically in a primary care setting. To a large extent they will be observed in patients with mild cognitive impairment or dementia having impaired recall and reduced capacity to participate in the diagnostic interview. The challenge to clinicians is complicated by the sizable number of medications that may be involved.
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Zarcone J, Napolitano D, Valdovinos M. Measurement of problem behaviour during medication evaluations. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2008; 52:1015-1028. [PMID: 18717764 DOI: 10.1111/j.1365-2788.2008.01109.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND The focus of this review is on methods that are currently being used to evaluate the behavioural effects of medication for individuals with intellectual disabilities. First we describe what has been identified as the ideal criteria for conducting clinical trials and how these criteria may be adapted to do less controlled evaluations. The central theme is a review of the biological measures (e.g. labs, drug levels), behavioural rating scales and direct observation measures that are often used to evaluate medication effects. Issues related to how the side effects of medication can affect behaviour will also be discussed. CONCLUSION The importance of encouraging communication and collaboration across all systems of care and the use of socially valid measures are discussed.
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Affiliation(s)
- J Zarcone
- University of Rochester Medical Center, Rochester, New York 14642, USA.
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27
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Repeated acute dystonia following administration of amisulpride and ziprasidone in a patient with iron deficiency. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:1615-6. [PMID: 18597910 DOI: 10.1016/j.pnpbp.2008.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Revised: 05/21/2008] [Accepted: 05/29/2008] [Indexed: 11/21/2022]
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Vostrikov VM, Uranova NA, Orlovskaya DD. Deficit of perineuronal oligodendrocytes in the prefrontal cortex in schizophrenia and mood disorders. Schizophr Res 2007; 94:273-80. [PMID: 17566708 DOI: 10.1016/j.schres.2007.04.014] [Citation(s) in RCA: 166] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2007] [Revised: 03/26/2007] [Accepted: 04/22/2007] [Indexed: 12/15/2022]
Abstract
OBJECTIVE A deficit of oligodendrocytes has been reported in the prefrontal cortex (PFC) in schizophrenia (SCH), bipolar disorder (BPD) and major depression (MDD). Also, a decreased size of pyramidal neurons has been detected in layer III in SCH and in mood disorders. Since oligodendrocytes have a trophic influence on neurons, reduced neuronal size reported in these disorders might be associated with the deficit in subpopulation of perineuronal oligodendrocytes. We hypothesized that deficit of perineuronal oligodendrocytes might occur in SCH and mood disorders. METHOD We estimated the number of oligodendroglial satellites of pyramidal neurons and the size of pyramidal neurons in layer III (Brodmann's area 9) in Nissl stained sections in SCH, BPD, MDD and normal controls. The Stanley Foundation Neuropathology Consortium brain collection consisted of 15 cases in each of four groups was used. RESULTS We detected a prominent and significant reduction in the number of perineuronal oligodendrocytes in the sublayers IIIa, IIIb and IIIc in SCH, BPD and MDD as compared to controls. The BPD group differed significantly from SCH group and from MDD group. There were no significant differences in somal sizes of pyramidal neurons in the sublayers IIIa, IIIb, IIIc between each of the psychiatric groups and the control group. Only BPD group showed significantly smaller neuronal size in sublayer IIIc as compared to controls. CONCLUSIONS Our data provide evidence for a deficit of perineuronal oligodendrocytes in severe mental disorders that may play a key role in the pathophysiology of SCH, BPD and MDD.
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Affiliation(s)
- Victor M Vostrikov
- Laboratory of Clinical Neuropathology, Mental Health Research Center, Zagorodnoe shosse 2, Moscow 117152, Russia.
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Cotter PE, O'Keeffe ST. Improvement in neuroleptic-induced akathisia with intravenous iron treatment in a patient with iron deficiency. J Neurol Neurosurg Psychiatry 2007; 78:548. [PMID: 17435196 PMCID: PMC2117825 DOI: 10.1136/jnnp.2006.101014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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García-Borreguero D, Allen RP, Benes H, Earley C, Happe S, Högl B, Kohnen R, Paulus W, Rye D, Winkelmann J. Augmentation as a treatment complication of restless legs syndrome: Concept and management. Mov Disord 2007; 22 Suppl 18:S476-84. [PMID: 17580331 DOI: 10.1002/mds.21610] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Augmentation constitutes the main complication of long-term dopaminergic treatment in restless legs syndrome (RLS). Although this condition was first described in 1996, and is characterized by an overall increase in severity of RLS symptoms (including earlier onset of symptoms during the day, faster onset of symptoms when at rest, expansion to the upper limbs and trunk, and shorter duration of the treatment effect), precise diagnostic criteria were not established until 2003. These criteria have recently been updated to form a new definition of augmentation based on multicentric studies. The present article reviews our current knowledge on clinical diagnosis, evaluation, pathophysiology, and treatment recommendations for this condition.
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Thomas D. The mineral depletion of foods available to us as a nation (1940-2002)--a review of the 6th Edition of McCance and Widdowson. Nutr Health 2007; 19:21-55. [PMID: 18309763 DOI: 10.1177/026010600701900205] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Over the past 60 years there have been fundamental changes in the quality and quantity of food available to us as a nation. The character, growing method, preparation, source and ultimate presentation of basic staples have changed significantly to the extent that trace elements and micronutrient contents have been severely depleted. This trend, established in a review of the 5th Edition of McCance & Widdowson's The Composition of Foods, is still apparent in this review of the 6th edition of the same work. Concurrently there has been a precipitous change towards convenience and pre-prepared foods containing saturated fats, highly processed meats and refined carbohydrates, often devoid of vital micronutrients yet packed with a cocktail of chemical additives including colourings, flavourings and preservatives. It is proposed that these changes are significant contributors to rising levels of diet-induced ill health. Ongoing research clearly demonstrates a significant relationship between deficiencies in micronutrients and physical and mental ill health.
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Affiliation(s)
- David Thomas
- Register of Nutritional Therapists, silverdale, East Sussex, UK.
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Abstract
Akathisia is a syndrome of motor restlessness, principally seen in association with antipsychotic medication. It is characterized by a subjective experience of mental unease and the urge to move, and manifests physically as particular patterns of restless movement. This review focuses on the signs and symptoms of the condition, and its diagnosis and assessment using the Barnes Akathisia Rating Scale. This scale was generated 15 years ago, and was derived from the findings of studies exploring the clinical features of antipsychotic-induced akathisia. Subsequently, its validity and reliability have been established, and it has been used extensively in clinical studies worldwide.
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Affiliation(s)
- Thomas R E Barnes
- Department of Psychological Medicine, Imperial College, Charing Cross Campus, London, UK.
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