The Immunological interplay in Schizophrenia: Impact of Clozapine and Risperidone treatment- A randomized study

Abstract

Background: Recent research highlights the neuroimmunological basis of Schizophrenia with an intrigue into biomarkers for Schizophrenia.

Methods: It was a prospective, randomized,  interventional study. Patients with ICD- 11 diagnosis of Schizophrenia were randomized to receive either Clozapine or Risperidone after baseline assessment [socio-demographic and clinical parameters, blood investigations ,immunoglobulins (IgM, IgA, IgG and IgE). Levels of immunoglobulin were reassessed at 6 and 12 weeks along with application of PANSS and Glasgow antipsychotic side effect check list.

Results: 30 patients in Clozapine group and 24 in Risperidone group completed the study. As compared to Risperidone group ,in the Clozapine group, IgG and IgM were higher at baseline and had a rise over 6 and 12 weeks, IgA  was lower at baseline and had a significant rise  from week 6 to week 12 and Ig E  showed a steady decline . For Clozapine group, at baseline , the correlation analysis showed Ig A to be significant for Positive , General and total  scores of  PANSS   while Ig G  was significantly correlated with Total scores of PANSS and  Ig M and Ig E  with General scores on PANSS

Conclusion: The change in immunoglobulin levels from baseline in both Clozapine and Risperidone groups validate the immunological basis of Schizophrenia .  There were no known immunodeficiency  found in either of the groups during the study period  ratifying that the immunodeficiency with Clozapine , if any , takes more than 12 weeks .