The Augmentation Effect of N-Acetyl Cysteine Antioxidant on Superoxide Dismutase Levels in Schizophrenic Patients Treated with Risperidone

Vita Camellia; Khairunnisa Khairunnisa; Muhammad Ichwan; Muhammad Surya Husada; Elmeida Effendy; Rusdiana Rusdiana; Deasy Hendriaty

doi:10.3889/oamjms.2021.6354

Authors

Vita Camellia Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0001-5774-3276
Khairunnisa Khairunnisa Department of Pharmacology, Faculty of Pharmacy, Universitas Sumatera Utara, Medan, Indonesia
Muhammad Ichwan Department of Pharmacology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Muhammad Surya Husada Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Elmeida Effendy Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Rusdiana Rusdiana Department of Biochemistry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Deasy Hendriaty Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.6354

Keywords:

Schizophrenia, Superoxide dismutase, N-acetyl cysteine

Abstract

Background: Schizophrenia affects approximately 1% of the population and in Indonesia the prevalence is about 400.000 people or as many as 1.7 per 10000 individuals of the population. Schizophrenia is characterized by positive symptoms, negative symptoms and also cognitive, aggressive, and affective symptoms, where negative symptoms reflect loss of function.

One important factor that plays a role in the pathophysiology of schizophrenia is the excessive production of free radical substances and the failure of the anti-oxidant defense process.

The aim of this study is to see how levels of superoxide dismutase change after N-acetylcystein augmentation in schizophrenic patients treated with risperidone. This study is a pre-post experimental test design, where schizophrenic patients meet inclusion and exclusion criteria. At baseline, and after 8 weeks of N-acetyl cysteine administration, patients were assessed at each of the time points using PANSS, and SOD was measured in blood at both time points.

The average negative PANSS score in the Risperidone + NAC baseline group was 29.93 (±1.83); in the Risperidone group was 29.83 (±1.19) (p = 0.87). The average negative PANSS score at the end of week 8 was statistically significantly different (p = 0.001) in the Risperidone + NAC group (17.40 ±1.84) and in the Riseridone group (21.00±0.74). The average baseline SOD levels in the Risperidone + NAC group were 63.57 (±22.44), and in the Risperidone group was 85.79 (±101.05). SOD levels at week 8 in the Risperidone + NAC group were 71.72 (±31.20) and in the Risperidone group 128.27 (±117.67). ∆ SOD in the Risperidone + NAC group was 8.15 (19.54) and ∆ SOD in the Risperidone group was 42.48± (54.30). p value of 0.028Research data shows that NAC augmentation can improve the negative symptoms of schizophrenia through reducing SOD levels in the blood.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Ministry of Health of Republic Indonesia: Riset Kesehatan Dasarl; 2013. [Last accessed on 2021 May 12]. Available from: https://www.depkes.go.id.

Chomczynski P, Sacchi N. Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem. 1987;162(1):156-9. https://doi.org/10.1016/0003-2697(87)90021-2 PMid:2440339 DOI: https://doi.org/10.1016/0003-2697(87)90021-2

Remington G, Foussias G, Fervahana G, Agid O, Takeuchi H, Lee J, et al. Treating negative symptoms in schizophrenia: An update. Curr Treat Options Psychiatry 2016;3:133-50. https://doi.org/10.1007/s40501-016-0075-8 PMid:27376016 DOI: https://doi.org/10.1007/s40501-016-0075-8

Gunes M, Altindag A, Bulut M, Demir S, Ibiloglu A, Kaya M, et al. Oxidative metabolism may be associated with negative symptoms in schizophrenia. Psychiatry Clin Psycopharmacol. 2017;27(1):54-61. https://doi.org/10.1080/24750573.2017.1293243 DOI: https://doi.org/10.1080/24750573.2017.1293243

Uma D, Chinnaswamy P. Oxidative injury and enzymic antioxidant misbalance in schizophrenics with positive, negative and cognitive symptoms. Afr J Biochem Res. 2008;2(4):92-7.

Djordjevic V, Lazarevis D, Cosic V, Knezevic M, Djordjevic V. Age-related changes of superoxide dismutase activity in patients with schizophrenia. Vojnosanit Pregl. 2017;74(1):31-7. https://doi.org/10.2298/vsp141202142d DOI: https://doi.org/10.2298/VSP141202142D

Farokhnia M, Azarkolah A, Adinehfar F, Khodaiae-arkadani M, Hosseini S, Yekehtaz H, et al. N-acetylcisteine as an adjunct to risperidone for treatment of negative symptoms in patients with chronic schizophrenia. Clin Neuropharmacol. 2013;36(6):185-92. https://doi.org/10.1097/wnf.0000000000000001 PMid:24201233 DOI: https://doi.org/10.1097/WNF.0000000000000001

Berk M, Malhi G, Gray L, Dean O. The promise of n-acetylcysteine in neuropsychiatry. Trends Pharmacol Sci. 2013;34(3):167-77. https://doi.org/10.1016/j.tips.2013.01.001 PMid:23369637 DOI: https://doi.org/10.1016/j.tips.2013.01.001

Bioassay Technology Laboratory, Human Superoxidase Dismutase ELISA. [Last accessed on 2021 May 12]. Available from: https://www.bt-laboratory.com.

Pazvantoglu O, Selek S, Okay T, Sengul C, Koray K, Dilbaz N, et al. Oxidative mechanisms in schizophrenia and their relationship with illness subtype and symptom profile. Psychiatry Clin Neurosci. 2009;63(5):693-700. https://doi.org/10.1111/j.1440-1819.2009.02015.x PMid:19788631 DOI: https://doi.org/10.1111/j.1440-1819.2009.02015.x