Relationship Between The Effect Of Antipsychoitcs And Neurodnocrine In Schizophrenia

Objective: Investigate the relation between cliniacal respinse and the serum levels of prolactin(PRL) and superoxide dismutase(SOD) in schizophrenics taking risperidone or clzapine.Methods: Withdrawed previous antipsychotics, the subjects were given either risperidone(lmg/d) or clozapine(100mg/d) for 3 days. Then gradually added to efficient dosage till day 14,maintained the dosage to day 28 .During the therapeutic periods, and other antipsychotics was not exerted except triazolam(0.25~0.5 mg/d) or artane(4mg/d) if necessaiy. It was measured for the serum levels of PRL and SOD in schizophrenics on day 4 and day 29.Meanwhile,The Brief Psychiatry Rating Scale(BPRS) was assessed pre-treatment and on the day 29 of post-treatment.Results: 1. PRL There was significantly higher PRL level in risperidone group(P<0.05), there was significantly higher PRL level in female subjects(P<0.05), and significantly higher efficiency rate of BPRS score on day 29 displayed in the male subjects with PRL > 69.2μg/L than in those with PRL<69.2ug/L(P<0.05).Similarly, significantly higher efficiency rate of positive symptoms subscore of BPRS on day 29 display in the male subjects with PRL > 69.2fig/L than in those with PRL<69.2μg/L(P<0.05). 2.SOD ?Positive correlation was found between the efficiency rate of positive symptoms subscore and ASOD ( y=0.298, P<0.05 ) ;Positive correlation was found between the efficiency rate of suspicious and hostility subscore and ASOD ( y=0.318, P<0.05 ) .(2)Significantly higher efficiency rate of positive symptoms subscore displayed in the male subjects(6/6) with SOD > 600μg/L than that in those (22/41) with SOD<600μg/L(P<0.05). (3) There displayedmoderate positive correlation between the level of SOD on day 29 and the efficiency rate of deficiency vigour (y=0.753, P<0.001) .Conclusions: 1.PRL (1)The male subjects with PRL > 69.2μg/L could beslow drug metablizers and taking ( 3.3±0.5 ) mg/d will reach therapeutic drug concentrations. By contrast, the subjects with PRL<69.2μg/L coule be fast metablizers and taking above ( 3.3-5.3 ) mg/d maybe reach therapeutic drug concentrations at least. Finally, neither day 4 or day 29 the level of PRL can not predict effective dose in clozapine group. CD Either male subjects or female subjects, the 4th day serum PRL is significantly higher in risperidone group than that in clozapine (P <0.001). Similarly, the 29th day serum PRL is significantly higher in risperidone group than that in clozapine (P <0.001). 2. SOD ㊣n risperidone group, day 29 SOD > 600|ag/L is one of the markers of positive symptoms amelioration . If there is no obvious change in SOD level but the patients show clinically significant amelioration, it is possible that the patients have hid their symptoms or pretend to feel well. In such cases doctors should make sure whether patients have took the medicine. (2)On the mechine of increasing the SOD level risperidone is different from that clozapine. The increase of SOD is correlation with the amelioration of positive symptoms in risperidone group while it is correlation with the remission of negative symptoms in clozapine group...