Document Detail

Lipid status, anti-oxidant enzyme defence and haemoglobin content in the blood of long-term clozapine-treated schizophrenic patients.
MedLine Citation:
PMID:  19962416     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Despite clozapine's unique effectiveness in patients with schizophrenia, a number of adverse effects have been recognised including abnormalities in lipid and glucose metabolisms. A high clozapine level in red blood cells (RBCs) and disturbed anti-oxidant enzyme activities in blood from schizophrenic patients prompted us to investigate lipid status and anti-oxidant enzyme defence in the blood of chronic schizophrenic patients on long-term clozapine therapy. METHODS: Plasma lipids, RBC anti-oxidant enzyme activities and haemoglobin (Hb) content were measured using established procedures in a group of eighteen chronically-medicated (average 630 days of therapy) schizophrenic patients receiving clozapine (average dose of 295 mg/day) and data were compared with those from a group of eighteen well-matched normal controls. RESULTS: Significantly higher levels of plasma triglycerides (by 47%, p<0.01) and total cholesterol and phospholipids (by 8% and 11%, respectively p<0.05) in patients were found. CuZn-superoxide dismutase (SOD1) activity was markedly higher (by 35%, p<0.001) while selenium-dependent glutathione peroxidase (GSH-Px1) activity was markedly lower (by 41%, p<0.001) in patients. In addition, metHb and HbA1c levels in patients were significantly higher (by 58% and 25%, respectively p<0.001). SOD1 activity was negatively correlated (p<0.001) to GSH-Px1 activity in patients. CONCLUSIONS: The findings support the view that ongoing oxidative stress may be a mechanism by which clozapine induces some adverse effects that increase the risk of diabetes and metabolic syndrome. If valid, this would indicate that in parallel with long-term clozapine treatment, schizophrenic patients could be encouraged to make some lifestyle changes to limit the detrimental effects of the medication.
Cedo Miljevic; Milan Nikolic; Aleksandra Nikolic-Kokic; David R Jones; Vesna Niketic; Dusica Lecic-Tosevski; Mihajlo B Spasic
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-12-03
Journal Detail:
Title:  Progress in neuro-psychopharmacology & biological psychiatry     Volume:  34     ISSN:  1878-4216     ISO Abbreviation:  Prog. Neuropsychopharmacol. Biol. Psychiatry     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-22     Completed Date:  2010-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211617     Medline TA:  Prog Neuropsychopharmacol Biol Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  303-7     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Elsevier Inc. All rights reserved.
Institute of Mental Health, Belgrade, Serbia.
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MeSH Terms
Anthropometry / methods
Antipsychotic Agents / pharmacology*,  therapeutic use
Body Composition / drug effects
Body Mass Index
Catalase / blood
Clozapine / pharmacology*,  therapeutic use
Erythrocytes / drug effects*,  enzymology
Glutathione Peroxidase / blood
Glutathione Reductase / blood
Hemoglobins / metabolism*
Lipids / blood*
Longitudinal Studies
Schizophrenia / blood*,  drug therapy
Superoxide Dismutase / blood
Reg. No./Substance:
0/Antipsychotic Agents; 0/Hemoglobins; 0/Lipids; 5786-21-0/Clozapine; EC; EC Peroxidase; EC Dismutase; EC Reductase

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