The Role of Total White Blood Cell Count in Antipsychotic Treatment for Patients with Schizophrenia

  • Authors: Zhang Y.1, Tao S.2, Coid J.2, Wei W.1, Wang Q.2, Yue W.3, Yan H.3, Tan L.4, Chen Q.5, Yang G.6, Lu T.7, Wang L.3, Zhang F.8, Yang J.9, Li K.10, Lv L.11, Tan Q.12, Zhang H.7, Ma X.5, Yang F.13, Li L.14, Wang C.5, Zhao L.2, Deng W.1, Guo W.1, Ma X.2, Zhang D.3, Li T.1
  • Affiliations:
    1. Department of Neurobiology and Affiliated Mental Health Center, Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine
    2. Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University
    3. Institute of Mental Health, Peking University Sixth Hospital
    4. Second Xiangya Hospital, Central South University
    5. Beijing Anding Hospital, Beijing Institute for Brain Disorders, Capital Medical University
    6. , Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital
    7. Peking University Sixth Hospital, Institute of Mental Health
    8. Wuxi Mental Health Center, Nanjing Medical University
    9. Institute of Mental Health, Tianjin Anding Hospital
    10. , Hebei Mental Health Center
    11. Second Affiliated Hospital, Xinxiang Medical University
    12. Department of Psychiatry, Xijing Hospital, Fourth Military Medical University
    13. , Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital,
    14. Second Xiangya Hospital,, Central South University,
  • Issue: Vol 22, No 1 (2024)
  • Pages: 159-167
  • Section: Neurology
  • URL: https://hum-ecol.ru/1570-159X/article/view/644273
  • DOI: https://doi.org/10.2174/1570159X21666230104090046
  • ID: 644273

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Abstract

Background:Total white blood cell count (TWBCc), an index of chronic and low-grade inflammation, is associated with clinical symptoms and metabolic alterations in patients with schizophrenia. The effect of antipsychotics on TWBCc, predictive values of TWBCc for drug response, and role of metabolic alterations require further study.

Methods:Patients with schizophrenia were randomized to monotherapy with risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone, perphenazine or haloperidol in a 6-week pharmacological trial. We repeatedly measured clinical symptoms, TWBCc, and metabolic measures (body mass index, blood pressure, waist circumference, fasting blood lipids and glucose). We used mixed-effect linear regression models to test whether TWBCc can predict drug response. Mediation analysis to investigate metabolic alteration effects on drug response.

Results:At baseline, TWBCc was higher among patients previously medicated. After treatment with risperidone, olanzapine, quetiapine, perphenazine, and haloperidol, TWBCc decreased significantly (p < 0.05). Lower baseline TWBCc predicted greater reductions in Positive and Negative Syndrome Scale (PANSS) total and negative scores over time (p < 0.05). We found significant mediation of TWBCc for effects of waist circumference, fasting low-density lipoprotein cholesterol, and glucose on reductions in PANSS total scores and PANSS negative subscale scores (p < 0.05).

Conclusion:TWBCc is affected by certain antipsychotics among patients with schizophrenia, with decreases observed following short-term, but increases following long-term treatment. TWBCc is predictive of drug response, with lower TWBCc predicting better responses to antipsychotics. It also mediates the effects of certain metabolic measures on improvement of negative symptoms. This indicates that the metabolic state may affect clinical manifestations through inflammation.

About the authors

Yamin Zhang

Department of Neurobiology and Affiliated Mental Health Center, Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine

Email: info@benthamscience.net

Shiwan Tao

Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University

Email: info@benthamscience.net

Jeremy Coid

Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University

Email: info@benthamscience.net

Wei Wei

Department of Neurobiology and Affiliated Mental Health Center, Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine

Email: info@benthamscience.net

Qiang Wang

Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University

Email: info@benthamscience.net

Weihua Yue

Institute of Mental Health, Peking University Sixth Hospital

Email: info@benthamscience.net

Hao Yan

Institute of Mental Health, Peking University Sixth Hospital

Email: info@benthamscience.net

Liwen Tan

Second Xiangya Hospital, Central South University

Email: info@benthamscience.net

Qi Chen

Beijing Anding Hospital, Beijing Institute for Brain Disorders, Capital Medical University

Email: info@benthamscience.net

Guigang Yang

, Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital

Email: info@benthamscience.net

Tianlan Lu

Peking University Sixth Hospital, Institute of Mental Health

Email: info@benthamscience.net

Lifang Wang

Institute of Mental Health, Peking University Sixth Hospital

Email: info@benthamscience.net

Fuquan Zhang

Wuxi Mental Health Center, Nanjing Medical University

Email: info@benthamscience.net

Jianli Yang

Institute of Mental Health, Tianjin Anding Hospital

Email: info@benthamscience.net

Keqing Li

, Hebei Mental Health Center

Email: info@benthamscience.net

Luxian Lv

Second Affiliated Hospital, Xinxiang Medical University

Email: info@benthamscience.net

Qingrong Tan

Department of Psychiatry, Xijing Hospital, Fourth Military Medical University

Email: info@benthamscience.net

Hongyan Zhang

Peking University Sixth Hospital, Institute of Mental Health

Email: info@benthamscience.net

Xin Ma

Beijing Anding Hospital, Beijing Institute for Brain Disorders, Capital Medical University

Email: info@benthamscience.net

Fude Yang

, Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital,

Email: info@benthamscience.net

Lingjiang Li

Second Xiangya Hospital,, Central South University,

Email: info@benthamscience.net

Chuanyue Wang

Beijing Anding Hospital, Beijing Institute for Brain Disorders, Capital Medical University

Email: info@benthamscience.net

Liansheng Zhao

Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University

Email: info@benthamscience.net

Wei Deng

Department of Neurobiology and Affiliated Mental Health Center, Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine

Email: info@benthamscience.net

Wanjun Guo

Department of Neurobiology and Affiliated Mental Health Center, Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine

Email: info@benthamscience.net

Xiaohong Ma

Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University

Email: info@benthamscience.net

Dai Zhang

Institute of Mental Health, Peking University Sixth Hospital

Email: info@benthamscience.net

Tao Li

Department of Neurobiology and Affiliated Mental Health Center, Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine

Author for correspondence.
Email: info@benthamscience.net

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