Blood lactate levels as a biomarker of antipsychotic side effects in patients with schizophrenia

Elmorsy, Ekramy; Shahda, Mohamed; Mahmoud, El-Hassanen M; Rakha, Shirien Amin; Shoaib, Mohammed

doi:10.1177/0269881115616385

Cited by 16 publications

(20 citation statements)

References 28 publications

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“…Elmorsy et al . measured blood lactate levels in patients with BD ( n = 56) or schizophrenia ( n = 32) . Compared to HC ( n = 28), the arterial blood lactate levels did not differ significantly ( P = 0.06) in BD and schizophrenia patients .…”

Section: Resultsmentioning

confidence: 98%

“…reported a significant lactate increase in the red blood cells of lithium‐treated BD patients and this increase is likely confounded by the fact that the blood sat at room temperature . Interestingly, the other two studies that did not report any significant differences in the peripheral lactate levels in BD compared to HC, excluded female participants. For these reasons, it is difficult to draw conclusions from the peripheral lactate data in BD.…”

Section: Discussionmentioning

confidence: 99%

“…After applying the inclusion and exclusion criteria to our search results, we identified 12 studies for the systematic review (Table 1) 4,7,8,[10][11][12][13][14][15][16][17][18] and five studies for the meta-analysis ( Fig. 1).…”

Section: Systematic Overviewmentioning

confidence: 99%

“…11 However, Elmorsy et al observed increase in blood lactate levels in response to treatment with antipsychotics and its extrapyramidal side-effects. 11 Although the results suggest that peripheral lactate may not be a biomarker for baseline BD or schizophrenia, the study did not separate patients with BD and schizophrenia. The study also excluded female patients on the basis that lactate levels can fluctuate with the menstrual cycle.…”

Section: Peripheral Lactatementioning

confidence: 99%

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Lactate in bipolar disorder: A systematic review and meta‐analysis

Kuang¹,

Duong²,

Jeong

et al. 2018

Psychiatry Clin Neurosci

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Bipolar disorder (BD) is a debilitating mood disorder with no specific biological marker. No novel treatment has been developed specifically for BD in the last several decades. Although the pathophysiology of BD remains unclear, there is strong evidence in the literature supporting the role of mitochondrial dysfunction in BD. In this systematic review, we identified and investigated 12 studies that measure lactate, which is a direct marker for mitochondrial dysfunction, in BD patients and healthy controls. Six studies measured lactate levels in the brain through proton echo-planar spectroscopy or magnetic resonance spectroscopy and five of these studies reported significantly elevated lactate levels in patients with BD. Two studies reporting cerebrospinal fluid lactate levels also found significantly elevated lactate in BD compared to healthy controls. Two other studies that reported peripheral lactate levels did not demonstrate significant findings. The meta-analysis, using standardized means and a random-effect model for five studies that measured brain lactate levels, corroborated the findings of the systematic review. Although the meta-analysis had a nearly significant overall effect (Z = 1.97, P = 0.05), high statistical heterogeneity (I = 86%) and possible publication bias suggest that the results should be interpreted with caution. To validate lactate abnormalities in BD, further studies should be carried out, including larger sample sizes, not excluding female patients, and using standardized methodologies. Peripheral lactate levels and other bioenergetic markers should be thoroughly studied to better understand the role of mitochondrial dysfunction in BD and to help develop more objective diagnostic tools.

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Systematic Overviewmentioning

confidence: 99%

Section: Peripheral Lactatementioning

confidence: 99%

See 2 more Smart Citations

Lactate in bipolar disorder: A systematic review and meta‐analysis

Kuang¹,

Duong²,

Jeong

et al. 2018

Psychiatry Clin Neurosci

View full text Add to dashboard Cite

show abstract

“…It is able to link energy metabolism, substrate availability, blood flow and neuronal activity throughout the brain [Rinholm and Bergersen, 2014; Baltan, 2015; Morland et al 2015]. It is also of interest that increased blood lactate levels may be an early biomarker of development of extrapyramidal side effects in patients on long-term antipsychotics [Elmorsy et al 2016].…”

Section: Importance Of Lactate In the Brainmentioning

confidence: 99%

Lactate in the brain: an update on its relevance to brain energy, neurons, glia and panic disorder

Riske

Thomas

Baker

et al. 2016

Therapeutic Advances in Psychopharmacology

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Abstract:Lactate is considered an important metabolite in the human body, but there has been considerable debate about its roles in brain function. Research in recent years has suggested that lactate from astrocytes may be crucial for supporting axonal function, especially during times of high metabolic demands or hypoglycemia. The astrocyte-neuron lactate transfer shuttle system serves a protective function to ensure a supply of substrates for brain metabolism, and oligodendrocytes appear to also influence availability of lactate. There is increasing evidence for lactate acting as a signaling molecule in the brain to link metabolism, substrate availability, blood flow and neuronal activity. This review will attempt to connect evidence to the relationship lactate has to panic disorder (PD), which suggests that its transporters, receptors or metabolism warrant investigation as potential therapeutic targets in PD.

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Progress in The Research of Lactate Metabolism Disruption And Astrocyte‐Neuron Lactate Shuttle Impairment in Schizophrenia: A Comprehensive Review

Zhang,

Tong,

et al. 2024

Advanced Biology

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Schizophrenia (SCZ) is a complex neuropsychiatric disorder widely recognized for its impaired bioenergy utilization. The astrocyte‐neuron lactate shuttle (ANLS) plays a critical role in brain energy supply. Recent studies have revealed abnormal lactate metabolism in SCZ, which is associated with mitochondrial dysfunction, tissue hypoxia, gastric acid retention, oxidative stress, neuroinflammation, abnormal brain iron metabolism, cerebral white matter hypermetabolic activity, and genetic susceptibility. Furthermore, astrocytes, neurons, and glutamate abnormalities are prevalent in SCZ with abnormal lactate metabolism, which are essential components for maintaining ANLS in the brain. Therefore, an in‐depth study of the pathophysiological mechanisms of ANLS in SCZ with abnormal lactate metabolism will contribute to a better understanding of the pathogenesis of SCZ and provide new ideas and approaches for the diagnosis and treatment of SCZ.

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Blood lactate levels as a biomarker of antipsychotic side effects in patients with schizophrenia

Abstract: These findings suggest elevated blood lactate levels may serve as early biomarkers for occurrence of extra-pyramidal symptoms in patients on chronic APs treatment.

Cited by 16 publications

References 28 publications

Lactate in bipolar disorder: A systematic review and meta‐analysis

Lactate in bipolar disorder: A systematic review and meta‐analysis

Lactate in the brain: an update on its relevance to brain energy, neurons, glia and panic disorder

Progress in The Research of Lactate Metabolism Disruption And Astrocyte‐Neuron Lactate Shuttle Impairment in Schizophrenia: A Comprehensive Review

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