Iranian Journal of Psychiatry 2018. 13(3):222-226.

Determining Pro-Oxidant Antioxidant Balance (PAB) and Total Antioxidant Capacity (TAC) in Patients with Schizophrenia
Farnaz Zahei Avval, Niloufar Mahmoudi, Abolfazl Nosrati Tirkani, Lida Jarahi, Daryoush Hamidi Alamdari, Seyed Alireza Sadjadi


Objective: Schizophrenia is a disease with unknown etiology. There is evidence suggesting that oxidative damage occurs in schizophrenia. Oxidative damage may arouse from imbalance between oxidant and anti-oxidant factors in cellular and tissue environment. Although it may not be the primary cause, it can worsen the disease and may be a reason of poor response to therapy in these patients. The present study aimed at evaluating the pro-oxidant antioxidant balance (PAB) and total antioxidant capacity (TAC) in serum of schizophrenia patients. PAB is an assay to determine the pro-oxidant load and antioxidant capacity in a single measurement.

Method: In this cross- sectional study, patients with diagnosis of schizophrenia, who referred to a psychiatry university hospital (Ibn-e-Sina Hospital) affiliated to Mashhad University of Medical Sciences, were enrolled. Patients' demographic characteristics and laboratory data were recorded from patients’ files. Serum PAB and TAC were measured using a special PAB assay and commercial kit, respectively. Data were analyzed using SPSS 16.

Results: A total of 84 individuals (42 schizophrenia cases and 42 healthy controls) participated in this study. Controls were age and sex-matched with the patients’ group. The mean TAC in the patient and control groups was 0.49±0.04 and 0.51±0.04 nmol/L, respectively (p = 0.16). PAB was higher in patients’ group than in controls (127.36±36.44 vs. 118.93±52.34 HK), however, this difference was not statistically significant (p = 0.09). The change was correlated with the chronicity of the disease.

Conclusion: Pro-oxidant antioxidant balance was elevated in serum of patients with schizophrenia. These data suggested the occurrence of oxidative stress during the progression of the disease. Lower antioxidant capacity might suggest that patients with schizophrenia could be more susceptible to oxidative stress damage.


Pro-Oxidant Antioxidant Balance, Reactive Oxygen Species, Schizophrenia, Total Antioxidant Capacity

Full Text:



Waddington JL, Buckley PF, Scully PJ, Lane A, O'Callaghan E, Larkin C. Course of psychopathology, cognition and neurobiological abnormality in schizophrenia: developmental origins and amelioration by antipsychotics? J Psychiatr Res 1998; 32: 179-189.

Reginsson GW, Ingason A, Euesden J, Bjornsdottir G, Olafsson S, Sigurdsson E, et al. Polygenic risk scores for schizophrenia and bipolar disorder associate with addiction. Addict Biol 2018; 23: 485-492.

Hambrecht M, Häfner H. Substance abuse and the onset of schizophrenia. Biol Psychiatry 1996; 40: 1155-1163.

Xu M-Q, Sun W-S, Liu B-X, Feng G-Y, Yu L, Yang L, et al. Prenatal malnutrition and adult schizophrenia: further evidence from the 1959-1961 Chinese famine. Schizophr Bull 2009; 35: 568-576.

Lanté F, Meunier J, Guiramand J, Maurice T, Cavalier M, de Jesus Ferreira M-C, et al. Neurodevelopmental damage after prenatal infection: role of oxidative stress in the fetal brain. Free Radic Biol Med 2007; 42: 1231-1245.

Wu D, Cederbaum AI. Alcohol, oxidative stress, and free radical damage. Alcohol Res Health 2003; 27: 277-284.

Gupta RK, Patel AK, Shah N, Chaudhary A, Jha U, Yadav UC, et al. Oxidative stress and antioxidants in disease and cancer. Asian Pac Cancer Prev 2014; 15: 4405-4409.

Besga A, Chyzhyk D, Gonzalez-Ortega I, Echeveste J, Graña-Lecuona M, Graña M, et al. White Matter Tract Integrity in Alzheimer's Disease vs. Late Onset Bipolar Disorder and Its Correlation with Systemic Inflammation and Oxidative Stress Biomarkers. Front Aging Neurosci 2017; 9: 179.

Naziroğlu M, Butterworth PJ. Protective effects of moderate exercise with dietary vitamin C and E on blood antioxidative defense mechanism in rats with streptozotocin-induced diabetes. Can J Appl Physiol 2005; 30: 172-185.

Dadheech G, Mishra S, Gautam S, Sharma P. Evaluation of antioxidant deficit in schizophrenia. Indian J Psychiatry 2008; 50: 16-20.

Raffa M, Mechri A, Othman LB, Fendri C, Gaha L, Kerkeni A. Decreased glutathione levels and antioxidant enzyme activities in untreated and treated schizophrenic patients. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33: 1178-83.

Bošković M, Grabnar I, Terzič T, Plesničar BK, Vovk T. Oxidative stress in schizophrenia patients treated with long-acting haloperidol decanoate. Psychiatry Res 2013; 210: 761-768.

Olney JW, Farber NB. Glutamate receptor dysfunction and schizophrenia. Arch Gen Psychiatry 1995; 52: 998-1007.

Davis KL, Kahn RS. Dopamine in schizophrenia: a review and reconceptualization. Am J Psychiatry 1991; 148: 1474-1486.

Matthysse S, editor Antipsychotic drug actions: a clue to the neuropathology of schizophrenia? Fed Proc 1973; 32: 200-205.

Zhang M, Zhao Z, He L, Wan C. A meta-analysis of oxidative stress markers in schizophrenia. Sci China Life Sci 2010; 53: 112-124.

Meister A, Anderson ME. Glutathione. Annu Rev Biochem 1983; 52: 711-760.

Raijmakers M, Peters W, Steegers E, Poston L. Amino thiols, detoxification and oxidative stress in pre-eclampsia and other disorders of pregnancy. Curr Pharm Des 2005; 11: 711-734.

Prior RL, Cao G. In vivo total antioxidant capacity: comparison of different analytical methods. Free Radical Biology and Medicine 1999; 27: 1173-1181.

Miller NJ, Rice-Evans C, Davies MJ, Gopinathan V, Milner A. A novel method for measuring antioxidant capacity and its application to monitoring the antioxidant status in premature neonates. Clin Sci (Lond) 1993; 84: 407-412.

Alamdari DH, Paletas K, Pegiou T, Sarigianni M, Befani C, Koliakos G. A novel assay for the evaluation of the prooxidant–antioxidant balance, before and after antioxidant vitamin administration in type II diabetes patients. Clin Biochem 2007; 40: 248-254.

Akyol Ö, Herken H, Uz E, Fadıllıoǧlu E, Ünal S, Söǧüt S, et al. The indices of endogenous oxidative and antioxidative processes in plasma from schizophrenic patients: the possible role of oxidant/antioxidant imbalance. Prog Neuropsychopharmacol Biol Psychiatry 2002; 26: 995-1005.

Pavlović D, Tamburić V, Stojanović I, Kocić G, Jevtović T, Đorđević V. Oxidative stress as marker of positive symptoms in schizophrenia. Facta Univ 2002; 9: 157-161.

Medina-Hernandez V, Ramos-Loyo J, Luquin S, Sánchez LC, García-Estrada J, Navarro-Ruiz A. Increased lipid peroxidation and neuron specific enolase in treatment refractory schizophrenics. Journal of psychiatric research 2007; 41: 652-658.

Brooks A, Chadwick C, Gelbard H, Cory-Slechta D, Federoff H. Paraquat elicited neurobehavioral syndrome caused by dopaminergic neuron loss. Brain Res 1999; 823: 1-10.

Nagano T, Mizuno M, Morita K, Nawa H. Pathological implications of oxidative stress in patients and animal models with schizophrenia: the role of epidermal growth factor receptor signaling. Neurotoxin Modeling of Brain Disorders—Life-long Outcomes in Behavioral Teratology: Springer; 2015.

Şimşek Ş, Gençoğlan S, Yüksel T, Kaplan İ, Alaca R, Aktaş H. Oxidative Stress and DNA Damage in Untreated First-Episode Psychosis in Adolescents. Neuropsychobiology 2016; 73: 92-97.

Womersley JS, Uys JD. S-Glutathionylation and Redox Protein Signaling in Drug Addiction. Prog Mol Biol Transl Sci 2016; 137: 87–121.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.