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The effect of electroconvulsive therapy on hematologic inflammatory markers in schizophrenia in association with type of antipsychotic medication

Objectives: In recent years there has been an increased interest on the role of inflammation in the pathophysiology of schizophrenia and a search for readily applicable prognostic markers. The impact of electroconvulsive therapy (ECT) on inflammatory function in schizophrenia is still unclear. The aim of this retrospective study is to compare pre- and post-ECT values of red cell distribution width (RDW), mean platelet volume (MPV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) which are considered to be inflammatory markers, and to discuss the findings in context of neuroinflammatory ethiology of schizophrenia. Methods: Inpatient files were reviewed via complete blood count (CBC), sociodemographic and clinical characteristics (e.g. gender, age, Body Mass Index (BMI), type of psychotropic medication). A total of 58 schizophrenic patients who underwent ECT were were compared in terms of pre- and post-ECT values of RDW, MPV, MCH, MCHC, NLR and PLR in association with type of psychotropic medication. Results: It was found that MPV, RDW, MCH and MCHC levels significantly decreased after ECT (p 0.05). When compared according to the type of psychotropic medication during ECT, MPV and MCHC were decreased after ECT in both typicaland atypical antipsychoticintervention groups (p < 0.05). ECT-related inflammatory marker changes were more likely to be associated with atypical antipsychotic medication use during ECT. Conclusions: Our results indicate that recurrent ECT sessions caused a change in the function of the immune system which might be considered to explain the therapeutic effects of ECT in schizophrenia.