Main Article Content
Cognitive Function, Homofanilic Acid, Schizophrenia
Background: Study of the supplementation of piracetam on cognitive function and plasma HVA levels in the treatment of schizophrenia in humans had never been conducted before. Meaningful findings in this study could provide information about optimizing pharmacological management in schizophrenic patients by adding piracetam and ultimately will improve the prognosis of the disorder. One of the simple and accurate tools for predicting the cognitive function and the prognosis of schizophrenia treatment is HVA level.
Objective: to determine the effect of piracetam supplementation on cognitive function and homovanillic acid levels in schizophrenic patients treated with risperidone.
Method: This study was experimental study, using a pre- and post-test study design with random group selection, in which variable measurements were carried out before and after treatment, conducted at RSKD Dadi South Sulawesi Province and the blood testing were send to the Research Laboratory of RSPTN UNHAS. The study subject were hospitalized schizophrenia patients who received a therapeutic dose of risperidone as many as 20 subject in treatment groups and 20 subject in control groups. The Moca-Ina were messure at weeks 0 & 8 eather in treatment group (who received Piracetam 2400 mg / day and risperidone 2-4 mg / day) and the contol group (who received risperidone 2-4 mg / day) for 8 weeks. Two measurements of Homovanilic Acid levels with ELISA were carried out in both groups, namely at the beginning of week 0 and weekend 8.
Results: MoCA-Ina values were significantly high in both grups with p <0.05, where the treatment group was higer than the control group with p = 0.015 (<0.05). Plasma homovanilic acid levels was increased in the treatment group, but there was no significant difference between before and after treatment p = 0.065 (> 0.05). There was no direct correlation between plasma homovanilic acid levels and cognitive function with p > 0.05.
Conclusion: supplementation of oral Piracetam 2400 mg/day and risperidone for 8 weeks, was better to improve cognitive function than risperidone alone, there was also a slight increases homofanilic acid levels.
3. Benson, K. L., & Feinberg, I. (2017). Chapter 139 - Schizophrenia. In Principles and Practice of Sleep Medicine. Available: Elsevier Inc. https://doi.org/10.1016/B978-0-323-24288-2.00139-2
4. Bhandari A, Voineskos D, Daskalakis Z. J, Rajji T. K, Blumberger D. M. A Review of Impaired Neuroplasticity in Schizophrenia Investigated with Non-invasive Brain Stimulation. Frontiers in Psychiatry. 2016; 7, 45. doi.org/10.3389/fpsyt.2016.00045
5. Cao, T., Li, N. N., & Cai, H. L. (2020). Candidate metabolic biomarkers for schizophrenia in CNS and periphery: Do any possible associations exist? Schizophrenia Research, 226(2020), 95–110.
6. Davidson, M., Kahn, R. S., Knott, P., Kaminsky, R., Cooper, M., Dumont, K., Apter, S., & Davis, K. L. (1991). Effects of Neuroleptic Treatment on Symptoms of Schizophrenia and Plasma Homovanillic Acid Concentrations. Archives of General Psychiatry, 48(10), 910–913.
7. Gasnier, M., Ellul, P., Plaze, M., & Ahad, P. A. (2021). A new look on an old issue: Comprehensive review of neurotransmitter studies in cerebrospinal fluid of patients with schizophrenia and antipsychotic effect on Monoamine’s metabolism. Clinical Psychopharmacology and Neuroscience, 19(3), 395–410.
8. Gruber, O., Chadha Santuccione, A., & Aach, H. (2014). Magnetic resonance imaging in studying schizophrenia, negative symptoms, and the glutamate system. Frontiers in psychiatry, 5, (32)1-11
9. Ibero-Baraibar, I., Perez-Cornago, A., Ramirez, M. J., Martínez, J. A., & Zulet, M. A. (2016). An increase in plasma homovanillic acid with cocoa extract consumption is associated with the alleviation of depressive symptoms in overweight or obese adults on an energy restricted diet in a randomized controlled trial. Journal of Nutrition, 146(4), 897S-904S.
10. Kabes, J., Erban, L., Hanzlicek, L., & Skondia, V. (1979). Biological correlates of piracetam clinical effects in psychotic patients. Journal of International Medical Research, 7(4), 277–284.
11. Nguyen, D. L. (2015). Does the Addition of Piracetam Safely and Effectively Improve Behavioral and or Cognitive Functions in Schizophrenia? PCOM Physician Assistant Studies Student Scholarship. Available: https://digitalcommons.pcom. edu/cgi/ viewcontent.cgi?article=1238&context=pa_systematic_reviews.
12. Noorbala, A. A., Akhondzadeh, S., Davari-Ashtiani, R., & Amini-Nooshabadi, H. (1999). Piracetam in the treatment of schizophrenia: Implications for the glutamate hypothesis of schizophrenia. Journal of Clinical Pharmacy and Therapeutics, 24(5), 369–374.
13. Nybfick, H., Wiesel, F., & Skett, P. (1979). Effects of Piracetam on Brain Monoamine Metabolism and Plasma Prolactin Levels in the Rat. Pharmacology, 238, 235–238.
14. Rago, L. K., Allikmets, L. H., & Zarkowsky, A. M. (1981). Effect of piracetam on the central dopaminergic transmission. NaunynSchmiedebergs archives of pharmacology, 340(1), 13–20.
15. Riset Kesehatan Dasar (Riskesdas). (2018). Persebaran Prevalensi Skizofrenia/Psikosis di Indonesia. Indonesia: Kementrian Kesehatan RI.
16. Riskesdas. (2018). Laporan Provinsi Sulawesi Selatan Riskesdas 2018. In Badan Penelitian Dan Pengembangan Kesehatan, 110(9)
17. Rubio, M. D., Drummond, J. B., & Meador-Woodruff, J. H. (2012). Glutamate receptor abnormalities in schizophrenia: Implications for innovative treatments. Biomolecules and Therapeutics, 20(1), 1–18.
18. Stępnicki, P., Kondej, M., & Kaczor, A. A. (2018). Current concepts and treatments of schizophrenia. Molecules, 23(8), 2087.
19. Suliman, N. A., CN, M. T., Moklas, M., Adenan, M. I., MT, H. B., & Basir, R. (2016). Establishing Natural Nootropics: Recent Molecular Enhancement Influenced by Natural Nootropic. Evidence-based Complementary and Alternative Medicine: Ecam, 2016, 4391375-4391375.
20. Takase, M., Kimura, H., Kanahara, N., Nakata, Y., & Iyo, M. (2020). Plasma monoamines change under dopamine supersensitivity psychosis in patients with schizophrenia: A comparison with first-episode psychosis. Journal of Psychopharmacology, 34(5), 540–547.
21. World Health Organization. (2017). Mental health atlas 2017-member state profile. Geneva: World Health Organization.
22. Winblad, B. (2005). Piracetam: A review of pharmacological properties and clinical uses. CNS Drug Reviews, 11(2), 169–182. https://doi.org/10.1111/j.1527-3458 .2005. tb00268.x
23. Zaitone, S. A., Abo-Elmatty, D. M., & Elshazly, S. M. (2012). Piracetam and vinpocetine ameliorate rotenone-induced Parkinsonism in rats. Indian Journal of Pharmacology, 44(6), 774–779.