Coagulation and inflammation markers during atypical or typical antipsychotic treatment in schizophrenia patients and drug-free first-degree relatives.
BACKGROUND
Clinical studies suggest that the second generation antipsychotics (APs) clozapine and olanzapine and to a lesser extent the typical antipsychotics may be associated with a procoagulant and proinflammatory state that promotes venous thromboembolism. We evaluated here several blood factors associated with coagulation and inflammation in AP-treated schizophrenia patients and their first-degree relatives.


METHODS
Procoagulant factors (fibrinogen and plasminogen activator inhibitor [PAI-1]), the anticoagulant factor antithrombin III [AT-III], and inflammation-related factors (C-reactive protein [CRP] and leptin) were assessed in patients chronically treated with clozapine (n=29), olanzapine (n=29), typical APs (n=30) and first degree relatives of clozapine (n=23) and olanzapine subjects (n=11).


RESULTS
The typical AP group had the highest CRP level (p=0.013) in spite of having the lowest body mass index (BMI). Patients as a single group had higher CRP levels than relatives (p=0.003). The typical AP group also had the highest AT-III levels (p=0.021). Fibrinogen levels did not differ between the groups (p=0.13). Olanzapine patients displayed the highest PAI-1 and leptin levels among the drug-treated subjects, but values were similar to those observed in their relatives, and were significantly correlated with the BMI.


CONCLUSIONS
A homogeneous negative profile of high inflammation and procoagulant factors along with low levels of anticoagulants was not detected in any group. While preliminary, our results suggest that the observed abnormalities were not related to a direct drug effect, but to elevated BMI (high PAI-1 and leptin in olanzapine-treated patients). We speculate that the high CRP in the typical AP group might be related to poor lifestyle habits, but this must we confirmed in future studies.
Carrizo
Edgardo
E
Institute of Clinical Research Dr. Américo Negrette, Zulia University Medical School, and University Psychiatric Hospital, Maracaibo, Venezuela.
Fernández
Virginia
V
Quintero
Jesús
J
Connell
Lissette
L
Rodríguez
Zulay
Z
Mosquera
Mônica
M
Acosta
Arnaldo
A
Baptista
Trino
T
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000990:Antithrombin III / Q000378:metabolism; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D020738:Leptin / Q000097:blood; D008019:Life Style; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D012307:Risk Factors; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy* / Q000235:genetics*; D013923:Thromboembolism / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D019851:Thrombophilia / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis
D014150:Antipsychotic Agents; D018836:Inflammation Mediators; D020738:Leptin; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D001569:Benzodiazepines; D000990:Antithrombin III; D005340:Fibrinogen; D002097:C-Reactive Protein; D003024:Clozapine; D000077152:Olanzapine