Effect of Paliperidone Combined with Sertraline in the Treatment of Schizophrenia and its Influence on Serum Neurofunctional Related Factors.

OBJECTIVE: This study aimed to evaluate the efficacy of paliperidone combined with sertraline in treating schizophrenia (SCZ) and its effect on serum neurofunctional factors. METHODS: A retrospective analysis was conducted on SCZ patients admitted between June 2020 and June 2021. Initially, 80 patients were treated with paliperidone, while 36 received a combination of paliperidone and sertraline. Propensity score matching based on 3 covariates resulted in 2 groups: the control group (paliperidone alone, n = 36) and the observation group (paliperidone + sertraline, n = 36). The clinical efficacy, adverse reactions, quality of life scores, serum biomarkers levels related to nerve and liver function, and anxiety and depression levels were compared between the 2 groups. RESULTS: The observation group demonstrated higher total effectiveness than the control group (p = 0.011). Post-treatment, the scores of all dimensions of quality of life in both groups were improved, and the observation group was higher than the control group (p < 0.001). Post-treatment, the observation group exhibited lower neuron-specific enolase (NSE) and higher neuregulin 1 (NRG1) levels than the control group (p < 0.001). The levels of aminotransferase (AST), total bilirubin (TBiL) and alanine aminotransferase (ALT) increased in both groups post-treatment (p < 0.001). The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-2 (IL-2) decreased in both groups post-treatment, and the observation group had lower levels of these cytokines compared to the control group after treatment (p < 0.001). Post-treatment, Hamilton Anxiety Scale (HAMA) score and Hamilton Depression Scale (HAMD) score decreased in both groups, with the observation group showing lower scores than the control group (p < 0.001). The changes in the scores of various dimensions of quality of life, HAMA and HAMD scores, neurofunctional factors and inflammatory markers levels in the observation group were greater than those in the control group (p < 0.001). There were no serious side effects during and after treatment in both groups. CONCLUSIONS: Paliperidone combined with sertraline effectively improves serum neuregulin levels in SCZ patients, alleviates negative emotional effects without causing liver or kidney damage, and demonstrates excellent clinical efficacy and safety.