The augmentation effect of n-acetyl cysteine antioxidant on superoxide dismutase levels in schizophrenic patients treated with risperidone

Abstract

BACKGROUND: Schizophrenia affects approximately 1% of the population and in Indonesia, the prevalence is about 400.000 people or as many as 1.7/10,000 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. AIM: The aim of this study is to see how levels of superoxide dismutase change after N-acetylcystein augmentation in schizophrenic patients treated with risperidone. METHODS: 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 (NAC) administration, patients were assessed at each of the time points using Positive and Negative Syndrome Scale (PANSS), and SOD was measured in blood at both time points. RESULTS: 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 risperidone group (21.00 ± 0.74). The average baseline superoxide dismutase (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). Δ SOD in the Risperidone + NAC group was 8.15 (19.54) and Δ SOD in the risperidone group was 42.48 ± (54.30). CONCLUSION: p = 0.028 research data show that NAC augmentation can improve the negative symptoms of schizophrenia through reducing SOD levels in the blood.