Meta-analysis of oxidative stress in schizophrenia

Joshua Flatow, Peter Buckley, Brian J. Miller

Research output: Contribution to journalArticlepeer-review

342 Scopus citations


Background Schizophrenia is associated with impaired antioxidant defense, including abnormal serum, plasma, and red blood cell (RBC) oxidative stress parameters. We performed a meta-analysis of these associations, considering the effect of clinical status and antipsychotic treatment after an acute exacerbation of psychosis. Methods We identified articles by searching PubMed, PsychInfo, and Institute for Scientific Information, and the reference lists of identified studies. Results Forty-four studies met the inclusion criteria. Total antioxidant status seemed to be a state marker, because levels were significantly decreased in cross-sectional studies of serum and plasma in first-episode psychosis (FEP) and significantly increased in longitudinal studies of antipsychotic treatment for acute exacerbations of psychosis (p <.01 for each). The RBC catalase and plasma nitrite seemed to be state-related markers, because levels in cross-sectional studies were significantly decreased in FEP (p <.01) and significantly increased in stable outpatients (p =.01). In contrast, RBC superoxide dismutase seemed to be a trait marker for schizophrenia, because levels in cross-sectional studies were significantly decreased in acutely relapsed inpatients, FEP, and stable outpatients (p <.01 for each). Conclusions Oxidative stress abnormalities in FEP suggest an effect that might be independent of antipsychotic medications. Although some parameters (total antioxidant status, RBC catalase, and plasma nitrite) might be state markers for acute exacerbations of psychosis, others (RBC superoxide dismutase) might be trait markers; however, more longitudinal studies are needed. Our findings suggest that oxidative stress might serve as a potential biomarker in the etiopathophysiology and clinical course of schizophrenia.

Original languageEnglish (US)
Pages (from-to)400-409
Number of pages10
JournalBiological Psychiatry
Issue number6
StatePublished - Sep 15 2013


  • Antioxidants
  • first-episode psychosis
  • meta-analysis
  • oxidative stress
  • relapse
  • schizophrenia

ASJC Scopus subject areas

  • Biological Psychiatry


Dive into the research topics of 'Meta-analysis of oxidative stress in schizophrenia'. Together they form a unique fingerprint.

Cite this