What is the clinical significance of hyperhomocysteinemia and psychotic episodes?

BMC PsychiatryScott Cunningham MD PhD, et al. | December 05, 2022



The pathophysiology underlying schizophrenia has not been established, although there is evidence that psychotic episodes reflect an oxidative stress imbalance, as has been demonstrated in other neurodegenerative disorders. Homocysteine is a pro-oxidant and a metabolite of methionine that interacts with N-methyl-D-aspartate receptors and inflammatory cytokines.

As shown in the current study, homocysteine levels are elevated in patients with schizophrenia during the first psychotic episode, thus adding support to the complex associations between homocysteine, oxidative stress, and inflammation.

One hundred nineteen patients with schizophrenia with first psychotic episode and not taking anti-psychotics and 81 healthy controls were enrolled in the study. Homocysteine levels were measured. Symptom severity was determined using the Positive and Negative Syndrome Scale (PANSS).

Homocysteine levels were elevated in patients with schizophrenia not taking anti-psychotics during the first psychotic episode; homocysteine levels were higher in males than females. The homocysteine levels correlated with the PANSS general psychopathology subscale and total scores. Elevated homocysteine levels were unrelated to age and body mass index.