The high prevalence of metabolic syndrome in persons with schizophrenia has spurred investigational efforts to study the mechanism beneath its pathophysiology. Early psychosis dysfunction is present across multiple organ systems. On this account, schizophrenia may be a multisystem disorder in which one organ system is predominantly affected and where other organ systems are also concurrently involved. Growing evidence of the overlapping neurobiological profiles of metabolic risk factors and psychiatric symptoms, such as an association with cognitive dysfunction, altered autonomic nervous system regulation, desynchrony in the resting-state default mode network, and shared genetic liability, suggest that metabolic syndrome and schizophrenia are connected via common pathways that are central to schizophrenia pathogenesis, which may be underpinned by oxytocin system dysfunction. Oxytocin, a hormone that involves in the mechanisms of food intake and metabolic homeostasis, may partly explain this piece of the puzzle in the mechanism underlying this association. Given its prosocial and anorexigenic properties, oxytocin has been administered intranasally to investigate its therapeutic potential in schizophrenia and obesity. Although the pathophysiology and mechanisms of oxytocinergic dysfunction in metabolic syndrome and schizophrenia are both complex and it is still too early to draw a conclusion upon, oxytocinergic dysfunction may yield a new mechanistic insight into schizophrenia pathogenesis and treatment.

Thirteen polyphenolics were isolated from fresh pods of Caesalpinia pulcherrima using various methods of column chromatography. The structures of these polyphenolics were elucidated as gallic acid (1), methyl gallate (2), 6-O-galloyl-D-glucoside (3), methyl 6-O-galloyl-β-D-glucoside (4), methyl 3,6-di-O-galloyl-α-D-glucopyranoside (5), gentisic acid 5-O-α-D-(6'-O-galloyl)glucopyranoside (6), guaiacylglycerol 4-O-β-D-(6'-O-galloyl)glucopyranoside (7), 3-methoxy-4-hydroxyphenol 1-O-β-D-(6'-O-galloyl)glucopyranoside (8), (+)-gallocatechin (9), (+)-catechin (10), (+)-gallocatechin 3-O-gallate (11), myricetin 3-rhamnoside (12), and ampelopsin (13). All isolated compounds were tested for their antioxidant activities in the 1,1-diphenyl-2-picrylhydrazyl (DPPH), hydroxyl, and peroxynitrite radicals scavenging assays. Among those compounds, 11, 12, and 2 exhibited the best DPPH-, hydroxyl-, and peroxynitrite radical-scavenging activities, respectively. Compound 7 is a new compound, and possesses better scavenging activities towards DPPH but has equivalent hydroxyl radical scavenging activity when compared to BHT. The paper is the first report on free radical scavenging properties of components of the fresh pods of Caesalpinia pulcherrima. The results obtained from the current study indicate that the free radical scavenging property of fresh pods of Caesalpinia pulcherrima may be one of the mechanisms by which this herbal medicine is effective in several free radical mediated diseases.

This therapeutic drug monitoring (TDM) study aimed to determine the role of olanzapine (OLZ) and N-desmethyl-OLZ (DMO) levels in the therapeutic efficacy of OLZ in patients with schizophrenia. Plasma concentrations of OLZ (C_OLZ) and DMO (C_DMO) in schizophrenic patients 12 hours post-dose were assessed. The correlations of C_OLZ and C_DMO with the various scores of the Positive and Negative Syndrome Scale (PANSS) were evaluated. A receiver operating characteristic curve (ROC) was utilized to identify the threshold C_OLZ and C_OLZ/C_DMO ratio for maintenance of satisfactory efficacy. A total of 151 samples from patients with schizophrenia were analyzed for individual C_OLZ and C_DMO levels. The mean C_OLZ and C_DMO levels were 37.0 ± 25.6 and 6.9 ± 4.7 ng/mL, respectively, and C_OLZ was ~50% higher in female or nonsmokers (p<0.01). In all patients, the daily dose of OLZ was positively correlated with C_OLZ and C_DMO. Linear relationships between C_OLZ and OLZ dose were observed in both nonsmokers and smokers (r_s = 0.306, 0.426, p<0.01), although C_DMO was only correlated with OLZ dose in smokers (r_s = 0.485, p<0.01) and not nonsmokers. In all patients, C_OLZ was marginally negatively correlated with the total PANSS score. The total PANSS score was significantly negatively correlated with the C_OLZ/C_DMO ratio (p<0.005), except in smokers. The ROC analysis identified a C_OLZ/C_DMO ratio ≥2.99 or C_OLZ ≥22.77 ng/mL as a predictor of maintenance of an at least mildly ill status (PANSS score ≤58) of schizophrenia in all patients. A significantly negative correlation between the steady-state C_OLZ/C_DMO ratio and total PANSS score was observed in Taiwanese schizophrenic patients. TDM of both OLZ and DMO levels could assist clinical practice when individualizing OLZ dosage adjustments for patients with schizophrenia.