Journal of Psychology & Psychotherapy
Open Access
ISSN: 2161-0487
ISSN: 2161-0487
Sumeesha Jaswal
University Institute of Pharmaceutical Sciences (UIPS), Chandigarh, India
Scientific Tracks Abstracts: J Psychol Psychother
The immune system has been shown to have a role in the pathophysiology of Schizophrenia, though its role as of now is not fully understood. The antipsychotics used in the treatment also have been shown to affect immune parameters like cytokines and immunoglobulins. The immunomodulatory effect of clozapine and its clinical implication in terms of morbidity is a topic of research in the recent times. To assess the levels of serum immunoglobulins and interleukins in patients of Schizophrenia on Clozapine at baseline and at 6 weeks and 12 weeks and study the correlation of Clozapine response with levels of serum immunoglobulins and interleukins. : It was an open label, randomized, comparative and prospective study. Patients with ICD 11 diagnosis of Schizophrenia who were not on any antipsychotic drug for more than 2 weeks, were randomized to 2 groups i.e. A (Clozapine) and B (Risperidone) after baseline assessment of socio- demographic and clinical parameters on PANSS. Baseline blood investigations, immunoglobulin (IgM, IgA, IgG and IgE) estimation and interleukin (IL-2, 6 and 8) estimation was done. Patients were followed at 6 weeks and 12 weeks and levels of immunoglobulin and interleukin were reassessed at 6 weeks and 12 weeks along with PANSS and Glasgow antipsychotic side effect check list. A total of 65 patients were enrolled in the study out of which 54 patients completed the 12 week follow up. 30 patients had been prescribed Clozapine (experimental group) while 24 were prescribed Risperidone (Control group). 33 (61.1%) patients were male while 21 (38.9%) patients were female. There was no statistical difference in terms of the socio-demographical profile between the two groups. Over the 12 weeks, a significant fall in all parameters of PANSS for the Clozapine group was seen. IgG and IgM had a significant rise over 6 and 12 weeks, while IgA had a significant rise at week 12. IgE levels saw a decrease in the levels over 12 weeks which was not significant. The side effect profile also showed a significant increase. A significant rise was seen in IL- 2 level with more individuals having greater than normal values over 12 weeks. IL- 6 had a significant fall at week 6 but not at week 12. IL-8 values did not differ significantly over 12 weeks. IL-8 had a negative correlation with the general psychopathology score at week 6 and this effect continued till week 12. No immunoglobulin had a correlation with IL level at week 12. Our study establishes that the interplay of immunological response in Schizophrenia is complex and varied. It can be concluded that the elevated cytokine levels (IL-6) validates the inflammatory basis of Schizophrenia wherein the cytokine modulates the key inflammatory process in the central nervous system. The elevated levels of IL-6 further signify that this inflammatory marker is elevated in Schizophrenia. Clozapine is also shown to have an immunological effect leading to changes in the interleukin as well as immunoglobulin levels.
Sumeesha Jaswal is a dedicated psychiatrist currently serving as a Senior Resident at Indira Gandhi Medical College in Shimla, Himachal Pradesh. With a burgeoning interest in research, clinical practice, and teaching, she actively contributes to the academic community through her publications and involvement in various research projects