THE EFFECT OF ADJUVANT THERAPY OF FOLIC ACID AND METHYLCOBALAMINE ON HOMOCYSTEINE LEVELS AND COGNITIVE FUNCTION IN SCHIZOPHRENIA PATIENTS
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Keywords
Schizophrenia, Risperidone, MoCA-Ina, Folic Acid, Methylcobalamin, Homocysteine, Cognitive
Abstract
Background: Cognitive dysfunction in schizophrenic patients has a very high prevalence. Antipsychotic drugs as the main treatment for patients with schizophrenia, provide a symptom response that is not always optimal. Adjunctive treatment with certain vitamins and minerals may be beneficial for people with psychiatric disorders due to a biological mechanism by which these nutrients may improve the cognitive symptoms of schizophrenia. Providing Folic Acid and Methylcobalamin required for homocysteine methylation to methionine and SAM synthesis (S-adenosylmethionine) causes a decrease in homocysteine levels and repairs cell damage and neuronal injury in the brain and improves psychiatric disorders, such as cognitive disorders.
Objectives: Determine the effect of folic acid adjuvant therapy and methylcobalamin on the homocysteine levels and cognitive function of schizophrenic patients receiving risperidone therapy
Methods: The experimental analysis research design by measuring pre- and post-tests with non-random group selection was carried out in January-March 2023 at Dadi RSKD South Sulawesi Province. The number of subjects was 48 according to the inclusion and exclusion criteria. Subjects were divided into 4 groups, namely the control group, folic acid, methylcobalamin, and folic acid plus methylcobalamin. To assess cognitive function, MoCA-Ina was used and homocysteine levels were measured Enzyme-Linked Immunosorbent Assay (ELISA). The Wilcoxon, Mann Whitney and Spearman correlation tests were carried out to see the significance.
Result: Value change of Montreal Cognitive Assessment-Indonesian version (MoCA-Ina) of schizophrenic patients receiving adjuvant therapy plus folic acid + methylcobalamin compared to groups methylcobalamin showed significant results on 4-8 week (p<0.05). Rate change of Homocysteine schizophrenic patients who received adjuvant therapy with folic acid plus methylcobalamin and the methylcobalamin group were more significant than the control group baseline up to 8 weeks (p<0,05)
Conclusion : Adjuvant therapy with methylcobalamin and folic acid + methylcobalamin is better at improving cognitive function. Administration of adjuvant therapy with methylcobalamin correlated strongly with improving cognitive function and reducing homocysteine levels, whereas adjuvant therapy with folic acid plus methylcobalamin correlated moderately with increasing cognitive function and reducing homocysteine levels.
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Nofianti Dewi
Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi
Saidah Syamsuddin
Derpartment of Psychiatry, Faculty of Medicine, Hasanuddin University, Jl. Perintis Kemerdekaan Km. 10, Tamalanrea, Makassar, South Sulawesi 90245
Kristian Liaury
Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi
Andi Alfian Zainuddin
Department of Public Health and Community Medicine, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi
Haerani Rasyid
Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi
Sonny Teddy Lisal
Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi