K. Wahlbeck et al., Current antipsychotic dose correlates to mononuclear cell counts in the cerebrospinal fluid of psychotic patients, PSYCHIAT R, 93(1), 2000, pp. 13-19
Elevated cerebrospinal fluid (CSF) angiotensin I-converting enzyme (ACE) le
vels have been evidenced in patients with schizophrenia who have been treat
ed with antipsychotics. In order to explore a possible mononuclear cell ori
gin of CSF ACE, the authors determined CSF ACE and CSF mononuclear cell cou
nts from 25 acutely psychotic patients, who had been drug-free for at least
4 months but started on conventional antipsychotic medication within a few
days before sampling. No correlations were found between CSF to serum ACE
ratio and CSF mononuclear cell counts. However, CSF total mononuclear cell
count, CSF lymphocyte count, and CSF mononuclear phagocyte count evidenced
significant positive correlations with current dose of antipsychotic medica
tion expressed as chlorpromazine equivalents. The authors conclude that no
indication of a relationship between mononuclear cells and CSF ACE activity
was found. Surprisingly, a relationship between chlorpromazine dose and CS
F mononuclear cell counts was found, which may indicate drug-related change
s in cell-mediated immunity. This finding needs replication and further cor
roboration in well-designed studies. (C) 2000 Elsevier Science Ireland Ltd.
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