New role of platelets in schizophrenia: predicting drug response
Background Elevated platelet count (PLTc) is associated with first-episode schizophrenia and adverse outcomes in individuals with precursory psychosis. However, the impact of antipsychotic medications on PLTc and its association with symptom improvement remain unclear.Aims We aimed to investigate ch...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-04-01
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| Series: | General Psychiatry |
| Online Access: | https://gpsych.bmj.com/content/37/2/e101347.full |
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| author | Tao Li Wei Wei Qiang Wang Yamin Zhang Wei Deng Rui Xue Wanjun Guo Xiaojing Li Hua Yu Yanghao Zheng Peiyan Ni Sugai Liang Xueyu Qi Xueli Yu Liansheng Zhao |
| author_facet | Tao Li Wei Wei Qiang Wang Yamin Zhang Wei Deng Rui Xue Wanjun Guo Xiaojing Li Hua Yu Yanghao Zheng Peiyan Ni Sugai Liang Xueyu Qi Xueli Yu Liansheng Zhao |
| author_sort | Tao Li |
| collection | DOAJ |
| description | Background Elevated platelet count (PLTc) is associated with first-episode schizophrenia and adverse outcomes in individuals with precursory psychosis. However, the impact of antipsychotic medications on PLTc and its association with symptom improvement remain unclear.Aims We aimed to investigate changes in PLTc levels following antipsychotic treatment and assess whether PLTc can predict antipsychotic responses and metabolic changes after accounting for other related variables.Methods A total of 2985 patients with schizophrenia were randomised into seven groups. Each group received one of seven antipsychotic treatments and was assessed at 2, 4 and 6 weeks. Clinical symptoms were evaluated using the positive and negative syndrome scale (PANSS). Additionally, we measured blood cell counts and metabolic parameters, such as blood lipids. Repeated measures analysis of variance was used to examine the effect of antipsychotics on PLTc changes, while structural equation modelling was used to assess the predictive value of PLTc on PANSS changes.Results PLTc significantly increased in patients treated with aripiprazole (F=6.00, p=0.003), ziprasidone (F=7.10, p<0.001) and haloperidol (F=3.59, p=0.029). It exhibited a positive association with white blood cell count and metabolic indicators. Higher baseline PLTc was observed in non-responders, particularly in those defined by the PANSS-negative subscale. In the structural equation model, PLTc, white blood cell count and a latent metabolic variable predicted the rate of change in the PANSS-negative subscale scores. Moreover, higher baseline PLTc was observed in individuals with less metabolic change, although this association was no longer significant after accounting for baseline metabolic values.Conclusions Platelet parameters, specifically PLTc, are influenced by antipsychotic treatment and could potentially elevate the risk of venous thromboembolism in patients with schizophrenia. Elevated PLTc levels and associated factors may impede symptom improvement by promoting inflammation. Given PLTc’s easy measurement and clinical relevance, it warrants increased attention from psychiatrists.Trial registration number ChiCTR-TRC-10000934. |
| format | Article |
| id | doaj-art-397588fffbde40578a86098607148ec3 |
| institution | Kabale University |
| issn | 2517-729X |
| language | English |
| publishDate | 2024-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | General Psychiatry |
| spelling | doaj-art-397588fffbde40578a86098607148ec32025-01-29T17:40:08ZengBMJ Publishing GroupGeneral Psychiatry2517-729X2024-04-0137210.1136/gpsych-2023-101347New role of platelets in schizophrenia: predicting drug responseTao Li0Wei Wei1Qiang Wang2Yamin Zhang3Wei Deng4Rui Xue5Wanjun Guo6Xiaojing Li7Hua Yu8Yanghao Zheng9Peiyan Ni10Sugai Liang11Xueyu Qi12Xueli Yu13Liansheng Zhao1412 Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, ChinaCleveland Clinic Foundation, Cleveland, OH, USA3 Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China1 Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People`s Hospital, Hangzhou, Zhejiang, China2 Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China1 Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People`s Hospital, Hangzhou, Zhejiang, China1 Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People`s Hospital, Hangzhou, Zhejiang, China1 Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People`s Hospital, Hangzhou, Zhejiang, ChinaDepartment of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA1 Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People`s Hospital, Hangzhou, Zhejiang, China1 Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People`s Hospital, Hangzhou, Zhejiang, China1 Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People`s Hospital, Hangzhou, Zhejiang, China1 Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People`s Hospital, Hangzhou, Zhejiang, China1 Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People`s Hospital, Hangzhou, Zhejiang, China3 Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, ChinaBackground Elevated platelet count (PLTc) is associated with first-episode schizophrenia and adverse outcomes in individuals with precursory psychosis. However, the impact of antipsychotic medications on PLTc and its association with symptom improvement remain unclear.Aims We aimed to investigate changes in PLTc levels following antipsychotic treatment and assess whether PLTc can predict antipsychotic responses and metabolic changes after accounting for other related variables.Methods A total of 2985 patients with schizophrenia were randomised into seven groups. Each group received one of seven antipsychotic treatments and was assessed at 2, 4 and 6 weeks. Clinical symptoms were evaluated using the positive and negative syndrome scale (PANSS). Additionally, we measured blood cell counts and metabolic parameters, such as blood lipids. Repeated measures analysis of variance was used to examine the effect of antipsychotics on PLTc changes, while structural equation modelling was used to assess the predictive value of PLTc on PANSS changes.Results PLTc significantly increased in patients treated with aripiprazole (F=6.00, p=0.003), ziprasidone (F=7.10, p<0.001) and haloperidol (F=3.59, p=0.029). It exhibited a positive association with white blood cell count and metabolic indicators. Higher baseline PLTc was observed in non-responders, particularly in those defined by the PANSS-negative subscale. In the structural equation model, PLTc, white blood cell count and a latent metabolic variable predicted the rate of change in the PANSS-negative subscale scores. Moreover, higher baseline PLTc was observed in individuals with less metabolic change, although this association was no longer significant after accounting for baseline metabolic values.Conclusions Platelet parameters, specifically PLTc, are influenced by antipsychotic treatment and could potentially elevate the risk of venous thromboembolism in patients with schizophrenia. Elevated PLTc levels and associated factors may impede symptom improvement by promoting inflammation. Given PLTc’s easy measurement and clinical relevance, it warrants increased attention from psychiatrists.Trial registration number ChiCTR-TRC-10000934.https://gpsych.bmj.com/content/37/2/e101347.full |
| spellingShingle | Tao Li Wei Wei Qiang Wang Yamin Zhang Wei Deng Rui Xue Wanjun Guo Xiaojing Li Hua Yu Yanghao Zheng Peiyan Ni Sugai Liang Xueyu Qi Xueli Yu Liansheng Zhao New role of platelets in schizophrenia: predicting drug response General Psychiatry |
| title | New role of platelets in schizophrenia: predicting drug response |
| title_full | New role of platelets in schizophrenia: predicting drug response |
| title_fullStr | New role of platelets in schizophrenia: predicting drug response |
| title_full_unstemmed | New role of platelets in schizophrenia: predicting drug response |
| title_short | New role of platelets in schizophrenia: predicting drug response |
| title_sort | new role of platelets in schizophrenia predicting drug response |
| url | https://gpsych.bmj.com/content/37/2/e101347.full |
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