Evaluation of the Effect of Barberry Root (Berberis Vulgaris) on the Prevention of Metabolic Syndrome Caused by Atypical Antipsychotic Drugs in Patients with Schizophrenia: A Three-Blind Placebo-Controlled Clinical Trial
Abstract
Objective: Metabolic syndrome is a potential side effect of atypical antipsychotics which are the current standard treatment for schizophrenia. Therefore, we aimed to examine the effect of barberry root (Berberis vulgaris) on the prevention of metabolic syndrome caused by atypical antipsychotic drugs in patients with schizophrenia.
Method: Our research was a three-blind randomized clinical trial. The participants included all patients who were diagnosed with schizophrenia through the SCID-5 questionnaire and based on the DSM-5-TR criteria by two psychiatric experts. These patients were randomly divided into intervention and placebo groups. During a three-month treatment period, the intervention group received three 500 mg capsules of barberry root extract daily, whereas the placebo group received the same capsules containing 500 mg of starch powder. Metabolic syndrome variables including fasting blood glucose, serum lipids (triglyceride and cholesterol), blood pressure, weight and waist circumference were measured before and after the treatment as outcome measure. Chi-square and t-tests were used for data analysis using SPSS-22 software.
Results: At the beginning of the study, there was no significant difference between the intervention group (n = 41) and the placebo group (n = 47) in terms of demographic factors, and pre-treatment assessments including weight, waist size, fasting blood HDL, fasting blood triglycerides and systolic and diastolic blood pressure and fasting blood glucose (P > 0.05). Within group analysis showed that some metabolic factors significantly increased in both groups after the treatment (P < 0.05). Indeed, in both groups, metabolic syndrome measures worsened after the three-month treatment period. The parameters of weight and waist size were significantly higher in the intervention group than the placebo group after treatment (P < 0.05).
Conclusion: Barberry root extract was not able to control the Effects of antipsychotic drugs on metabolic syndrome in schizophrenia.
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10. Bourque F, van der Ven E, Malla A. A meta-analysis of the risk for psychotic disorders among first- and second-generation immigrants. Psychol Med. 2011;41(5):897-910.
11. Kirkbride J, Coid JW, Morgan C, Fearon P, Dazzan P, Yang M, et al. Translating the epidemiology of psychosis into public mental health: evidence, challenges and future prospects. J Public Ment Health. 2010;9(2):4-14.
12. Biological insights from 108 schizophrenia-associated genetic loci. Nature. 2014;511(7510):421-7.
13. Brown AS, Begg MD, Gravenstein S, Schaefer CA, Wyatt RJ, Bresnahan M, et al. Serologic evidence of prenatal influenza in the etiology of schizophrenia. Arch Gen Psychiatry. 2004;61(8):774-80.
14. Brown AS, Derkits EJ. Prenatal infection and schizophrenia: a review of epidemiologic and translational studies. Am J Psychiatry. 2010;167(3):261-80.
15. Sullivan PF, Kendler KS, Neale MC. Schizophrenia as a complex trait: evidence from a meta-analysis of twin studies. Arch Gen Psychiatry. 2003;60(12):1187-92.
16. Khaleghi A, Mohammadi MR, Shahi K, Nasrabadi AM. Computational Neuroscience Approach to Psychiatry: A Review on Theory-driven Approaches. Clin Psychopharmacol Neurosci. 2022;20(1):26-36.
17. Clarke MC, Tanskanen A, Huttunen M, Whittaker JC, Cannon M. Evidence for an interaction between familial liability and prenatal exposure to infection in the causation of schizophrenia. Am J Psychiatry. 2009;166(9):1025-30.
18. Handunnetthi L, Saatci D, Hamley JC, Knight JC. Maternal immune activation downregulates schizophrenia genes in the foetal mouse brain. Brain Commun. 2021;3(4):fcab275.
19. Kuo CJ, Yang SY, Liao YT, Chen WJ, Lee WC, Shau WY, et al. Second-generation antipsychotic medications and risk of pneumonia in schizophrenia. Schizophr Bull. 2013;39(3):648-57.
20. Lund BC, Perry PJ, Brooks JM, Arndt S. Clozapine use in patients with schizophrenia and the risk of diabetes, hyperlipidemia, and hypertension: a claims-based approach. Arch Gen Psychiatry. 2001;58(12):1172-6.
21. Suttajit S, Pilakanta S. Prevalence of metabolic syndrome and its association with depression in patients with schizophrenia. Neuropsychiatr Dis Treat. 2013;9:941-6.
22. Vancampfort D, Sweers K, Probst M, Maurissen K, Knapen J, Minguet P, et al. Association of the metabolic syndrome with physical activity performance in patients with schizophrenia. Diabetes Metab. 2011;37(4):318-23.
23. Kwon CY, Lee B, Ha DJ. Herbal medicine for behavioral and psychological symptoms of dementia: A protocol for systematic review. Medicine (Baltimore). 2021;100(8):e24577.
24. May BH, Lit M, Xue CC, Yang AW, Zhang AL, Owens MD, et al. Herbal medicine for dementia: a systematic review. Phytother Res. 2009;23(4):447-59.
25. Meliani N, Dib Mel A, Allali H, Tabti B. Hypoglycaemic effect of Berberis vulgaris L. in normal and streptozotocin-induced diabetic rats. Asian Pac J Trop Biomed. 2011;1(6):468-71.
26. Doroodgar A, Arbabi M, Razavi MR, Mohebali M, Sadr F. Treatment of cutaneous leishmaniasis in murine model by hydro alcoholic Essence of Artemisia sieberi. 2008;2(2):42-7.
27. El-On J, Jacobs GP, Witztum E, Greenblatt CL. Development of topical treatment for cutaneous leishmaniasis caused by Leishmania major in experimental animals. Antimicrob Agents Chemother. 1984;26(5):745-51.
28. Asemani S, Montazeri V, Baradaran B, Tabatabiefar MA, Pirouzpanah S. The Effects of Berberis Vulgaris Juice on Insulin Indices in Women with Benign Breast Disease: A Randomized Controlled Clinical Trial. Iran J Pharm Res. 2018;17(Suppl):110-21.
29. Shidfar F, Ebrahimi SS, Hosseini S, Heydari I, Shidfar S, Hajhassani G. The Effects of Berberis vulgaris Fruit Extract on Serum Lipoproteins, apoB, apoA-I, Homocysteine, Glycemic Control and Total Antioxidant Capacity in Type 2 Diabetic Patients. Iran J Pharm Res. 2012;11(2):643-52.
30. Safari Z, Farrokhzad A, Ghavami A, Fadel A, Hadi A, Rafiee S, et al. The effect of barberry (Berberis vulgaris L.) on glycemic indices: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2020;51:102414.
31. Hadi A, Arab A, Ghaedi E, Rafie N, Miraghajani M, Kafeshani M. Barberry (Berberis vulgaris L.) is a safe approach for management of lipid parameters: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2019;43:117-24.
32. Iloon Kashkooli R, Najafi SS, Sharif F, Hamedi A, Hoseini Asl MK, Najafi Kalyani M, et al. The effect of berberis vulgaris extract on transaminase activities in non-alcoholic Fatty liver disease. Hepat Mon. 2015;15(2):e25067.
33. Tabeshpour J, Imenshahidi M, Hosseinzadeh H. A review of the effects of Berberis vulgaris and its major component, berberine, in metabolic syndrome. Iran J Basic Med Sci. 2017;20(5):557-68.
34. Firouzi S, Malekahmadi M, Ghayour-Mobarhan M, Ferns G, Rahimi HR. Barberry in the treatment of obesity and metabolic syndrome: possible mechanisms of action. Diabetes Metab Syndr Obes. 2018;11:699-705.
35. Zilaee M, Safarian M, Kermany T, Emamian M, Mobarhan M, Ferns GAA. Effect of barberry treatment on blood pressure in patients with metabolic syndrome. J Natural Products. 2015;8:59-63.
36. Pérez-Rubio KG, González-Ortiz M, Martínez-Abundis E, Robles-Cervantes JA, Espinel-Bermúdez MC. Effect of berberine administration on metabolic syndrome, insulin sensitivity, and insulin secretion. Metab Syndr Relat Disord. 2013;11(5):366-9.
37. Lazavi F, Mirmiran P, Sohrab G, Nikpayam O, Angoorani P, Hedayati M. The barberry juice effects on metabolic factors and oxidative stress in patients with type 2 diabetes: A randomized clinical trial. Complement Ther Clin Pract. 2018;31:170-4.
2. Goff DC, Bottiglieri T, Arning E, Shih V, Freudenreich O, Evins AE, et al. Folate, homocysteine, and negative symptoms in schizophrenia. Am J Psychiatry. 2004;161(9):1705-8.
3. Smith RC, Lindenmayer JP, Davis JM, Cornwell J, Noth K, Gupta S, et al. Cognitive and antismoking effects of varenicline in patients with schizophrenia or schizoaffective disorder. Schizophr Res. 2009;110(1-3):149-55.
4. Alavi SS, Mohammadi MR, Hooshyari Z, Mohammadi Kalhori S, Salehi M, Salmanian M, et al. Epidemiology of Psychotic Disorders Based on Demographic Variables in Iranian Children and Adolescents. Iran J Psychiatry. 2021;16(1):1-12.
5. Caroff SN, Leong SH, Roberts CB, Berkowitz RM, Campbell EC. Correlates of the Abnormal Involuntary Movement Scale in Veterans With Tardive Dyskinesia. J Clin Psychopharmacol. 2020;40(4):373-80.
6. Foulds J, Russ C, Yu CR, Zou KH, Galaznik A, Franzon M, et al. Effect of varenicline on individual nicotine withdrawal symptoms: a combined analysis of eight randomized, placebo-controlled trials. Nicotine Tob Res. 2013;15(11):1849-57.
7. Hawley C, Fineberg N, Roberts A, Baldwin D, Sahadevan A, Sharman V. The use of the Simpson Angus Scale for the assessment of movement disorder: A training guide. Int J Psychiatry Clin Pract. 2003;7(4):349-2257.
8. Mohammadi MR, Ahmadi N, Khaleghi A, Mostafavi SA, Kamali K, Rahgozar M, et al. Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents. Iran J Psychiatry. 2019;14(1):1-15.
9. Al Rihani SB, Deodhar M, Darakjian LI, Dow P, Smith MK, Bikmetov R, et al. Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models. Drugs Aging. 2021;38(11):977-94.
10. Bourque F, van der Ven E, Malla A. A meta-analysis of the risk for psychotic disorders among first- and second-generation immigrants. Psychol Med. 2011;41(5):897-910.
11. Kirkbride J, Coid JW, Morgan C, Fearon P, Dazzan P, Yang M, et al. Translating the epidemiology of psychosis into public mental health: evidence, challenges and future prospects. J Public Ment Health. 2010;9(2):4-14.
12. Biological insights from 108 schizophrenia-associated genetic loci. Nature. 2014;511(7510):421-7.
13. Brown AS, Begg MD, Gravenstein S, Schaefer CA, Wyatt RJ, Bresnahan M, et al. Serologic evidence of prenatal influenza in the etiology of schizophrenia. Arch Gen Psychiatry. 2004;61(8):774-80.
14. Brown AS, Derkits EJ. Prenatal infection and schizophrenia: a review of epidemiologic and translational studies. Am J Psychiatry. 2010;167(3):261-80.
15. Sullivan PF, Kendler KS, Neale MC. Schizophrenia as a complex trait: evidence from a meta-analysis of twin studies. Arch Gen Psychiatry. 2003;60(12):1187-92.
16. Khaleghi A, Mohammadi MR, Shahi K, Nasrabadi AM. Computational Neuroscience Approach to Psychiatry: A Review on Theory-driven Approaches. Clin Psychopharmacol Neurosci. 2022;20(1):26-36.
17. Clarke MC, Tanskanen A, Huttunen M, Whittaker JC, Cannon M. Evidence for an interaction between familial liability and prenatal exposure to infection in the causation of schizophrenia. Am J Psychiatry. 2009;166(9):1025-30.
18. Handunnetthi L, Saatci D, Hamley JC, Knight JC. Maternal immune activation downregulates schizophrenia genes in the foetal mouse brain. Brain Commun. 2021;3(4):fcab275.
19. Kuo CJ, Yang SY, Liao YT, Chen WJ, Lee WC, Shau WY, et al. Second-generation antipsychotic medications and risk of pneumonia in schizophrenia. Schizophr Bull. 2013;39(3):648-57.
20. Lund BC, Perry PJ, Brooks JM, Arndt S. Clozapine use in patients with schizophrenia and the risk of diabetes, hyperlipidemia, and hypertension: a claims-based approach. Arch Gen Psychiatry. 2001;58(12):1172-6.
21. Suttajit S, Pilakanta S. Prevalence of metabolic syndrome and its association with depression in patients with schizophrenia. Neuropsychiatr Dis Treat. 2013;9:941-6.
22. Vancampfort D, Sweers K, Probst M, Maurissen K, Knapen J, Minguet P, et al. Association of the metabolic syndrome with physical activity performance in patients with schizophrenia. Diabetes Metab. 2011;37(4):318-23.
23. Kwon CY, Lee B, Ha DJ. Herbal medicine for behavioral and psychological symptoms of dementia: A protocol for systematic review. Medicine (Baltimore). 2021;100(8):e24577.
24. May BH, Lit M, Xue CC, Yang AW, Zhang AL, Owens MD, et al. Herbal medicine for dementia: a systematic review. Phytother Res. 2009;23(4):447-59.
25. Meliani N, Dib Mel A, Allali H, Tabti B. Hypoglycaemic effect of Berberis vulgaris L. in normal and streptozotocin-induced diabetic rats. Asian Pac J Trop Biomed. 2011;1(6):468-71.
26. Doroodgar A, Arbabi M, Razavi MR, Mohebali M, Sadr F. Treatment of cutaneous leishmaniasis in murine model by hydro alcoholic Essence of Artemisia sieberi. 2008;2(2):42-7.
27. El-On J, Jacobs GP, Witztum E, Greenblatt CL. Development of topical treatment for cutaneous leishmaniasis caused by Leishmania major in experimental animals. Antimicrob Agents Chemother. 1984;26(5):745-51.
28. Asemani S, Montazeri V, Baradaran B, Tabatabiefar MA, Pirouzpanah S. The Effects of Berberis Vulgaris Juice on Insulin Indices in Women with Benign Breast Disease: A Randomized Controlled Clinical Trial. Iran J Pharm Res. 2018;17(Suppl):110-21.
29. Shidfar F, Ebrahimi SS, Hosseini S, Heydari I, Shidfar S, Hajhassani G. The Effects of Berberis vulgaris Fruit Extract on Serum Lipoproteins, apoB, apoA-I, Homocysteine, Glycemic Control and Total Antioxidant Capacity in Type 2 Diabetic Patients. Iran J Pharm Res. 2012;11(2):643-52.
30. Safari Z, Farrokhzad A, Ghavami A, Fadel A, Hadi A, Rafiee S, et al. The effect of barberry (Berberis vulgaris L.) on glycemic indices: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2020;51:102414.
31. Hadi A, Arab A, Ghaedi E, Rafie N, Miraghajani M, Kafeshani M. Barberry (Berberis vulgaris L.) is a safe approach for management of lipid parameters: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2019;43:117-24.
32. Iloon Kashkooli R, Najafi SS, Sharif F, Hamedi A, Hoseini Asl MK, Najafi Kalyani M, et al. The effect of berberis vulgaris extract on transaminase activities in non-alcoholic Fatty liver disease. Hepat Mon. 2015;15(2):e25067.
33. Tabeshpour J, Imenshahidi M, Hosseinzadeh H. A review of the effects of Berberis vulgaris and its major component, berberine, in metabolic syndrome. Iran J Basic Med Sci. 2017;20(5):557-68.
34. Firouzi S, Malekahmadi M, Ghayour-Mobarhan M, Ferns G, Rahimi HR. Barberry in the treatment of obesity and metabolic syndrome: possible mechanisms of action. Diabetes Metab Syndr Obes. 2018;11:699-705.
35. Zilaee M, Safarian M, Kermany T, Emamian M, Mobarhan M, Ferns GAA. Effect of barberry treatment on blood pressure in patients with metabolic syndrome. J Natural Products. 2015;8:59-63.
36. Pérez-Rubio KG, González-Ortiz M, Martínez-Abundis E, Robles-Cervantes JA, Espinel-Bermúdez MC. Effect of berberine administration on metabolic syndrome, insulin sensitivity, and insulin secretion. Metab Syndr Relat Disord. 2013;11(5):366-9.
37. Lazavi F, Mirmiran P, Sohrab G, Nikpayam O, Angoorani P, Hedayati M. The barberry juice effects on metabolic factors and oxidative stress in patients with type 2 diabetes: A randomized clinical trial. Complement Ther Clin Pract. 2018;31:170-4.
| Files | ||
| Issue | Vol 18 No 3 (2023) | |
| Section | Short Communication(s) | |
| DOI | https://doi.org/10.18502/ijps.v18i3.13015 | |
| Keywords | ||
| Antipsychotics Barberry Root Metabolic Syndrome Schizophrenia | ||
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How to Cite
1.
Rostami H, Babaali F, Moradi L, Golfakhrabadi F, Abdi L. Evaluation of the Effect of Barberry Root (Berberis Vulgaris) on the Prevention of Metabolic Syndrome Caused by Atypical Antipsychotic Drugs in Patients with Schizophrenia: A Three-Blind Placebo-Controlled Clinical Trial. Iran J Psychiatry. 2023;18(3):362-368.
