Association of Serum Trace Elements with Schizophrenia and Effects of Antipsychotic Treatment

Variation of serum trace elements was previously reported in schizophrenia (SZ) patients; however, whether such variation is resulted from the antipsychotic treatment remains obscure. A case control study consist of 165 SZ inpatients and 614 healthy controls measured serum magnesium (Mg), Copper (Cu), calcium (Ca), phosphorus (Phos), iron (Fe), and zinc (Zn) to investigate the relationship of trace elements and SZ. The SZ patients were further followed up (average 3.8 weeks) to evaluate the effects of antipsychotic treatment on the trace element concentrations using repeated measures ANOVA analysis. The results showed that higher concentrations of Mg and Phos and lower concentrations of Ca, Fe, and Zn were significant in SZ patients than that of controls (P < 0.01). The age was positively correlated with Fe and Cu, and negatively correlated with Ca, Phos, and Zn in controls (P < 0.05). Fe in male SZ patients was significantly higher than in female (P < 0.001), as well as in paranoid SZ and acute SZ (P < 0.05). Phos significantly increased after risperidone, clozapine, and aripiprazole treatment (P < 0.05), while Cu was decreased after clozapine and aripiprazole treatment. Zn significantly decreased particularly in mixed type SZ, acute SZ, and schizotypal SZ after antipsychotic treatment. These results suggested that higher concentration of Phos and lower concentration of Fe and Zn have important implications for the risk of SZ and the antipsychotic treatment is likely to result in the decreased Fe and increased Phos in the clinical subtypes of SZ.