ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Psychopharmacology
Antipsychotics Lower Peripheral Markers of Inflammation in Drug-naïve Early Psychosis: A Pilot Study
Provisionally accepted
- 1National Institute of Mental Health (Czechia), Prague, Czechia
- 2Univerzita Karlova 3 lekarska fakulta, Prague, Czechia
- 3Psychiatricka nemocnice Bohnice, Prague, Czechia
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Introduction: Neuroinflammation is increasingly recognized as a core pathophysiological mechanism in schizophrenia and can be indirectly assessed through peripheral inflammatory markers. Therefore, this pilot study investigated the impact of antipsychotic treatment on inflammation in patients with first-episode psychosis (FEP) who were antipsychotic-naive at study entry. Methods: Thirty-three drug-naïve FEP patients provided blood samples upon admission (V0) and follow-up (V1), from which peripheral inflammatory markers—i.e., neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), and systemic immune-inflammation index (SII)—were calculated. Antipsychotic doses during continuous hospitalization between V0 and V1 (34 days, IQR: 21-49 days) were converted into cumulative chlorpromazine equivalents (cCPZ). Results: In multiple regression models adjusting for sex, age, BMI, DUP, and clozapine use, cumulative antipsychotic exposure significantly predicted reductions in ΔNLR (p = 0.048), ΔMLR (p = 0.041), ΔPLR (p = 0.028), and ΔSII (p = 0.028). All associations remained significant following false discovery rate adjustment (pFDR = 0.048 for all outcomes). Conclusion: These findings suggest a consistent dose-dependent anti-inflammatory effect during early antipsychotic treatment in FEP. Given the exploratory nature of this study, larger studies are needed to confirm these findings.
Keywords: antipsychotic medication, cumulative chlorpromazine equivalents, early psychosis, first-episode schizophrenia, Monocyte-to-lymphocyte ratio, Neuroinflammation, Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio
Received: 16 Dec 2025; Accepted: 28 Jan 2026.
Copyright: © 2026 Šafářová, Kolenic, Tašková, Čapek, Fürstová and Spaniel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Nicole Šafářová
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