Abstract
This study evaluates the clinical efficacy and biomarker effects of quetiapine combined with magnesium valproate in patients with schizophrenia. A total of 156 patients diagnosed with schizophrenia were randomly assigned to 2 groups: 1 received magnesium valproate monotherapy (n = 78), and the other received combined therapy with quetiapine and magnesium valproate (n = 78). Both groups were treated for 8 weeks. Serum brain-derived neurotrophic factor and GFAP concentrations were measured before and after treatment. Clinical efficacy was assessed using the positive and negative syndrome scale, Montreal Cognitive Assessment, and a schizophrenia-specific quality of life scale. Adverse events were monitored and compared. After 8 weeks of treatment, serum brain-derived neurotrophic factor concentrations increased significantly in the combination group (628.63 ± 154.09 pg/mL) compared with the monotherapy group (520.78 ± 133.44 pg/mL, P < .001). Meanwhile, GFAP concentrations decreased to 2.16 ± 0.23 μg/L in the combination group versus 2.36 ± 0.30 μg/L in the monotherapy group (P < .001). Positive and negative syndrome scale total scores decreased more substantially in the combination group (101.41 ± 11.36 to 74.54 ± 8.41) than in the monotherapy group (101.33 ± 9.85 to 89.22 ± 9.06, P < .001). Montreal Cognitive Assessment scores improved to 26.15 ± 3.36 in the combination group compared with 22.24 ± 3.64 in the monotherapy group (P < .001). Quality of life scores also improved more in the combination group (total: 73.41 ± 5.49) than in the monotherapy group (82.92 ± 5.57, P < .001; lower scores indicate better quality of life). The incidence of adverse reactions was comparable between groups, occurring in 8 of 78 patients (10.26%) in the combination group and 7 of 78 patients (8.97%) in the monotherapy group (χ²=0.074, P = .786). Quetiapine combined with magnesium valproate offers superior clinical benefits over monotherapy in patients with schizophrenia. It significantly improves psychiatric symptoms, cognitive function, and quality of life, likely through modulation of neurotrophic and glial activity, with good tolerability and safety.