The Effectiveness of Meloxicam Adjuvant Therapy against Negative Symptoms and Neutrophil Lymphocyte Ratio (NLR) in Schizophrenic Patients
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Highlights:
1. The NLR value can show the role of neuroinflammation in schizophrenic patients.
2. Meloxicam as adjuvant therapy can improve negative symptoms and changes in the NLR in schizophrenic patients.
Abstract
Introduction: Neutrophil-lymphocyte ratio is a simple and affordable marker of inflammation that has recently been widely used to assess systemic inflammation in psychiatric patients. This study aimed to determine and analyze the effectiveness of meloxicam as adjuvant therapy to improve negative symptoms and changes in the neutrophil-lymphocyte ratio (NLR) in schizophrenic patients.
Methods: This was a quasi-experimental study using a single-blind, pretest–post-test design. Subjects were determined using a purposive sampling technique based on inclusion criteria. This study examined 34 samples and divided them into two groups. The treatment group consisted of 17 subjects who received adjuvant therapy with meloxicam 15 mg/day for 4 weeks and 17 subjects in the control group. Data collection was obtained from medical records, interviews, field notes, positive scale, negative scale, and general psychopathology scale (PANSS) assessment sheets, and blood NLR examinations. Data analysis used SPSS 25.0.
Results: The negative subscale PANSS score in the treatment group decreased lower than in the control group, with p-value = 0.640. However, the decrease in NLR values was more significant in the treatment group than in the control group, with p-value = 0.094. There was a decrease in the negative subscale PANSS scores and clinical NLR scores, but it was not statistically significant.
Conclusion: Adjuvant therapy with Meloxicam, given once a day for four weeks, had an effect on decreasing the negative subscale PANSS score and NLR scores for schizophrenic patients at Dr. Arif Zainudin Regional Mental Hospital (RSJD), Surakarta, clinically, but it was not statistically significant.
Cho M, Lee TY, Kwak Y Bin, et al. Adjunctive Use of Anti-Inflammatory Drugs for Schizophrenia: A Meta-Analytic Investigation of Randomized Controlled Trials. Aust N Z J Psychiatry 2019; 53: 742–759.
Zheng W, Cai D-B, Yang X-H, et al. Adjunctive Celecoxib for Schizophrenia: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials. J Psychiatr Res 2017; 92: 139–146.
Karageorgiou V, Milas GP, Michopoulos I. Neutrophil-to-Lymphocyte Ratio in Schizophrenia: A Systematic Review and Meta-Analysis. Schizophr Res 2019; 206: 4–12.
Lin T, Liu GA, Perez E, et al. Systemic Inflammation Mediates Age-Related Cognitive Deficits. Front Aging Neurosci 2018; 10: 236.
Du C, Cai F, Zidan MA, et al. Reservoir Computing Using Dynamic Memristors for Temporal Information Processing. Nat Commun 2017; 8: 2204.
Sanguinetti A, Kurani K, Davies J. The Many Reasons Your Mileage May Vary: Toward a Unifying Typology of Eco-Driving Behaviors. Transp Res Part D Transp Environ 2017; 52: 73–84.
Lolobua MFIP, Khairina K, Wardani IAK, et al. Negative Symptoms Management in Schizophrenia. J Psikiatri Surabaya 2021; 10: 6–12.
Syulthoni ZB, Gunadi IGN. Cognitive Enhancement Therapy in Schizophrenia. J Psikiatri Surabaya 2020; 9: 7–13.
Fitryasari R, Nursalam N, Yusuf A, et al. Development of a Family Resiliency Model to Care of Patients with Schizophrenia. Scand J Caring Sci 2021; 35: 642–649.
Jessica L, Fithriyah I, Ardani IGAI. The Importance of Family Support in Successful Treatment Adherence of Schizophrenic Patient. J Psikiatri Surabaya 2021; 10: 83–91.
Arisyna A, Sustini F, Muhdi N. Anxiety Level and Risk Factors in Medical Students. JUXTA J Ilm Mhs Kedokt Univ Airlangga 2020; 11: 79–82.
Purwono H. Pengaruh Pemberian Terapi Tambahan Meloxicam terhadap Kadar Hs-CRP dan Skor PANSS pada Pasien Skizofrenia di RSJD Arif Zainudin Surakarta. Universitas Sebelas Maret, https://digilib.uns.ac.id/dokumen/detail/58379/Pengaruh-Pemberian-Terapi-Tambahan-Meloxicam-terhadap-Kadar-Hs-Crp-dan-Skor-Panss-pada-Pasien-Skizofrenia-di-Rsjd-Arif-Zainudin-Surakarta (2018).
Müller N, Schwarz MJ. A Psychoneuroimmunological Perspective to Emil Kraepelins Dichotomy: Schizophrenia and Major Depression as Inflammatory CNS Disorders. Eur Arch Psychiatry Clin Neurosci 2008; 258 Suppl: 97–106.
Xie P, Wu K, Zheng Y, et al. Prevalence of Childhood Trauma and Correlations between Childhood Trauma, Suicidal Ideation, and Social Support in Patients with Depression, Bipolar Disorder, and Schizophrenia in Southern China. J Affect Disord 2018; 228: 41–48.
Charlson FJ, Ferrari AJ, Santomauro DF, et al. Global Epidemiology and Burden of Schizophrenia: Findings From the Global Burden of Disease Study 2016. Schizophr Bull 2018; 44: 1195–1203.
Buchanan RW, Weiner E, Kelly DL, et al. Anti-Inflammatory Combination Therapy for the Treatment of Schizophrenia. J Clin Psychopharmacol 2020; 40: 444–450.
Akhondzadeh S, Tabatabaee M, Amini H, et al. Celecoxib as Adjunctive Therapy in Schizophrenia: A Double-Blind, Randomized and Placebo-Controlled Trial. Schizophr Res 2007; 90: 179–185.
Kantrowitz JT. Managing Negative Symptoms of Schizophrenia: How Far Have We Come? CNS Drugs 2017; 31: 373–388.
Wolters FJ, Chibnik LB, Waziry R, et al. Twenty-Seven-Year Time Trends in Dementia Incidence in Europe and the United States: The Alzheimer Cohorts Consortium. Neurology 2020; 95: e519–e531.
Sandberg AA, Steen VM, Torsvik A. Is Elevated Neutrophil Count and Neutrophil-to-Lymphocyte Ratio a Cause or Consequence of Schizophrenia?-A Scoping Review. Frontiers in Psychiatry 2021; 12: 728990.
Brinn A, Stone J. Neutrophil-Lymphocyte Ratio across Psychiatric Diagnoses: A Cross-Sectional Study Using Electronic Health Records. BMJ Open 2020; 10: e036859.
Zhou X, Wang X, Li R, et al. Neutrophil-to-Lymphocyte Ratio is Independently Associated with Severe Psychopathology in Schizophrenia and is Changed by Antipsychotic Administration: A Large-Scale Cross-Sectional Retrospective Study. Front Psychiatry 2020; 11: 581061.
Özdin S, Sarisoy G, Böke Ö. A Comparison of the Neutrophil-Lymphocyte, Platelet-Lymphocyte and Monocyte-lymphocyte Ratios in Schizophrenia and Bipolar Disorder Patients – A Retrospective File Review. Nord J Psychiatry 2017; 71: 509–512.
Jaehne A, Unbehaun T, Feige B, et al. Sleep Changes in Smokers before, during and 3 Months after Nicotine Withdrawal. Addict Biol 2015; 20: 747–755.
Fond G, D'Albis M-A, Jamain S, et al. The Promise of Biological Markers for Treatment Response in First-Episode Psychosis: A Systematic Review. Schizophr Bull 2015; 41: 559–573.
Girshkin L, Matheson SL, Shepherd AM, et al. Morning Cortisol Levels in Schizophrenia and Bipolar Disorder: A Meta-Analysis. Psychoneuroendocrinology 2014; 49: 187–206.
Semiz M, Yildirim O, Canan F, et al. Elevated Neutrophil/Lymphocyte Ratio in Patients with Schizophrenia. Psychiatr Danub 2014; 26: 220–225.
Tong Z, Zhu J, Wang J-J, et al. The Neutrophil-Lymphocyte Ratio is Positively Correlated with Aggression in Schizophrenia. Biomed Res Int 2022; 2022: 4040974.
Bioque M, Catarina Matias-Martins A, Llorca-Bofí V, et al. Neutrophil to Lymphocyte Ratio in Patients with a First Episode of Psychosis: A Two-Year Longitudinal Follow-Up Study. Schizophr Bull 2022; 48: 1327–1335.
Yüksel RN, Ertek IE, Dikmen AU, et al. High Neutrophil-Lymphocyte Ratio in Schizophrenia Independent of Infectious and Metabolic Parameters. Nord J Psychiatry 2018; 72: 336–340.
Velasco Á, Rodríguez-Revuelta J, Olié E, et al. Neutrophil-to-Lymphocyte Ratio: A Potential New Peripheral Biomarker of Suicidal Behavior. Eur Psychiatry 2020; 63: e14.
Salsabila KN, Khairina K, Djuari L. Profile of Chronic Mental Disorder Patients with or without Suicide Ideation in the Psychiatric Ward of Dr. Soetomo General Hospital, Surabaya. JUXTA J Ilm Mhs Kedokt Univ Airlangga 2021; 12: 48–53.
Savitz SI, Chopp M, Deans R, et al. Stem Cell Therapy as an Emerging Paradigm for Stroke (STEPS) II. Stroke 2011; 42: 825–829.
Lin P, Sun J, Lou X, et al. Consensus on Potential Biomarkers Developed for Use in Clinical Tests for Schizophrenia. Gen Psychiatry 2022; 35: e100685.
Weickert CS, Weickert TW, Pillai A, et al. Biomarkers in Schizophrenia: A Brief Conceptual Consideration. Dis Markers 2013; 35: 3–9.
Perkovic MN, Erjavec GN, Strac DS, et al. Theranostic Biomarkers for Schizophrenia. Int J Mol Sci; 18. Epub ahead of print March 2017.
Halldorsdottir T, Binder EB. Gene í— Environment Interactions: From Molecular Mechanisms to Behavior. Annu Rev Psychol 2017; 68: 215–241.
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