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Platelet and serum calcium and magnesium concentration in suicidal and non-suicidal schizophrenic patients

It is well established that calcium (Ca) plays important role in the regulation of neurotransmitters in the central nervous system (CNS). Main processes modulated by Ca and involved in the aetiology of schizophrenia are alteration in dopamine (DA) and glutamate neurotransmitter system. The DA hypothesis is hyperactivity of dopaminergic transmission while glutamate postulates hypofunction of glutamate Ca-permeable N-methyl-D-aspartate (NMDA) receptors. Hypotheses of Ca-imbalance are based on examination of platelets in schizophrenic patients and suggested that increased cytosolic Ca may be the primary molecular abnormality (1, 2). Intracellular effects of magnesium (Mg) ions are opposite to Ca-ions in competition at K- ion channels, in Na/K-ATP-ase activity, cAMP/cGMP concentration and Ca-ion currents in pre- and postsynaptic membranes. Antipsychotic drugs with Mg supplement may reverse consequences of abnormalities in Ca-signalling.Subjects Group of schizophrenic patients was consisted of 23 patients with attempted suicide (S-SCH) and 48 patients without suicidal behaviour (K-SCH) diagnosed according to ICD-10 diagnosis (F20.0) with or without Intentional self-harm (X60-X84). The control group (K) was made of 99 voluntary blood donors. All patients were on psychopharmacological therapy. Methods The Mg and Ca concentration in platelets and serum was determined by atomic absorption spectrophotometry on the AAnalyst 200 (Perkin Elmer, USA).RESULTS One-way ANOVA test and by manifold application of the SNK post hoc test it has been established higher concentration of platelet Mg (µmol/109 platelets) (p=0.009, F=4.89) and lower concentration of serum Ca concentration (mmol/L) (p<0.001, F=19.18) in S-SCH group of patients and higher concentration of platelet Ca/Mg ratio in K-SCH group of patients (p=0.006, F=5.37).DISCUSSION AND CONCLUSION The research has shown disbalance of the two electrolytes in platelets of the suicidal and non-suicidal schizophrenic patients. Higher Ca/Mg ratio in platelet of non-suicidal patients confirm indirect higher Ca concentration. Higher Mg concentration in platelet of suicidal patients, considered an Ca antagonist, may represent a compensatory attempt to restrain Ca-activity. The platelet Ca concentration is higher but not statistically significant, while concentration in serum is lower in suicidal patients. DA release is Ca-dependent process triggered by Ca-influx upon activation NMDA receptors or Ca-release from intracellular stores. While inhibition of NMDA receptors reduces Ca-influx through these channels, the overall effect is an increase Ca-level in large neuronal population. This mechanism may facilitate excitotoxic neuronal damage or exaggerated DA release (3, 4). From the obtained result we can conclude that Mg supplement with antipsychotics may be beneficial for treatment of schizophrenic patients. Lack of large-scale, double-blinde, placebo controlled clinical trials is the main limited factor in making strong recommendation.

calcium; magnesium; schizophrenia; platelet

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