Iron Deficiency May Be Behind The Dangers Of Antipsychotic Drugs

TreasureVibe

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Because someone mentioned to me on this forum that iron was important for dopamine metabolism, and antipsychotic drugs cause dangerous cardiovascular side effects through its interference with the body's dopamine system, I decided to do a Google search for "antipsychotic drugs iron". I know that the body uses dopamine to control the heart functions, and that antipsychotic drugs use has been associated with an increased risk of heart failure, cardiovascular disease and sudden death in studies.

I came across the following study paper, which suggests that antipsychotic drugs can induce an iron deficiency:

Antipsychotic Drugs Induced Iron Deficiency Anemia in Schizophrenic Patients

Abstract

Published Online: December 2013

Background
: Psychiatric manifestations and its association with the antipsychotic drugs induced IDA is still controversial. Iron deficiency is the most evident risk factor for developing neuroleptic-induced extra pyramidal symptoms (EPSs), on the basis of emerging evidences; here we report the iron deficiency anemia observed in the on antipsychotic drug treated schizophrenic patients.

Methods: The hematological and absolute indices, morphological and serum iron indices assessment was focused on 120 Pakistani schizophrenic patients, who were on the chronic treatment of antipsychotic drug particularly haloperidol for more than 12 weeks of clinical practice, and 44 normal controls.

Results: Marked decrease (p<0.0001) was observed in the hematological
indices such as hemoglobin, RBCs count and packed cell volume while
marked but insignificant decrease was observed in the level of mean cell volume (MCV) in the schizophrenic patients. The morphological assessment shows significant alterations on the peripheral blood smear of the schizophrenic patients with hypochromic (>10%) and microcytic cells as compared to normocytic - normochromic controls. The serum ferritin and iron levels in these patients were within the normal range. However, significant (p<0.0001) inverse correlation was observed in the level of serum iron and ferritin with increased TIBC level in the schizophrenic patients as
compared to the normal individuals.

Conclusion: The present study clearly delineates on the basis of sequential analysis, morphological and biochemical assessment that the type of microcytic-hypochromic anemia is iron deficiency anemia. Moreover, the clinical manifestation of iron deficiency anemia are varied and related to its severity and duration.

Full study paper available to download as PDF at: Article Detail - International Journal of Advanced Research


A Google search for "mitral valve iron" shows up multiple studies that show iron deficiency as an independent predictor for mitral valve regurgitation, and that it is common in patients who suffer from valvular heart disease and patients who undergo cardiac valve replacement:

The association of functional mitral regurgitation and anemia in patients with non-ischemic dilated cardiomyopathy. - PubMed - NCBI

[Iron deficiency following implantation of a heart valve prosthesis]. - PubMed - NCBI

[Anemia in patients with artificial heart valves (author's transl)]. - PubMed - NCBI

Traumatic Hemolysis with Iron Deficiency Anemia in Patients with Aortic Valve Lesions | Annals of Internal Medicine | American College of Physicians

Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis

[Investigations of iron and folate levels in serum after implantation of heart valve prostheses (author's transl)]. - PubMed - NCBI

[Haemolysis after heart valve replacement (author's transl)]. - PubMed - NCBI


A Google search for "heart disease iron" comes up with a lot of studies including:

Iron deficiency and heart disease: ironclad evidence? - PubMed - NCBI

Anemia in chronic heart failure: can we treat? What to treat? - PubMed - NCBI

Anemia and iron deficiency in heart failure. - PubMed - NCBI

Low iron levels linked with increased risk of heart disease

[Anaemia in chronic heart failure]. - PubMed - NCBI

[Diagnosis and treatment of anemia in heart failure patients]. - PubMed - NCBI

Recognition and treatment of anemia in the setting of heart failure due to systolic left ventricular dysfunction. - PubMed - NCBI

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.030099#


So all in all, I think antipsychotic drugs can cause iron deficiency anemia, which impairs/decreases dopamine metabolism/production, which in part causes heart disease like heart failure.
 
Last edited:

tankasnowgod

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Joined
Jan 25, 2014
Messages
8,131
Because someone mentioned to me on this forum that iron was important for dopamine metabolism, and antipsychotic drugs cause dangerous cardiovascular side effects through its interference with the body's dopamine system, I decided to do a Google search for "antipsychotic drugs iron". I know that the body uses dopamine to control the heart functions, and that antipsychotic drugs use has been associated with an increased risk of heart failure, cardiovascular disease and sudden death in studies.

I came across the following study paper, which suggests that antipsychotic drugs can induce an iron deficiency:

Antipsychotic Drugs Induced Iron Deficiency Anemia in Schizophrenic Patients

Abstract

Published Online: December 2013

Background
: Psychiatric manifestations and its association with the antipsychotic drugs induced IDA is still controversial. Iron deficiency is the most evident risk factor for developing neuroleptic-induced extra pyramidal symptoms (EPSs), on the basis of emerging evidences; here we report the iron deficiency anemia observed in the on antipsychotic drug treated schizophrenic patients.

Methods: The hematological and absolute indices, morphological and serum iron indices assessment was focused on 120 Pakistani schizophrenic patients, who were on the chronic treatment of antipsychotic drug particularly haloperidol for more than 12 weeks of clinical practice, and 44 normal controls.

Results: Marked decrease (p<0.0001) was observed in the hematological
indices such as hemoglobin, RBCs count and packed cell volume while
marked but insignificant decrease was observed in the level of mean cell volume (MCV) in the schizophrenic patients. The morphological assessment shows significant alterations on the peripheral blood smear of the schizophrenic patients with hypochromic (>10%) and microcytic cells as compared to normocytic - normochromic controls. The serum ferritin and iron levels in these patients were within the normal range. However, significant (p<0.0001) inverse correlation was observed in the level of serum iron and ferritin with increased TIBC level in the schizophrenic patients as
compared to the normal individuals.

Conclusion: The present study clearly delineates on the basis of sequential analysis, morphological and biochemical assessment that the type of microcytic-hypochromic anemia is iron deficiency anemia. Moreover, the clinical manifestation of iron deficiency anemia are varied and related to its severity and duration.

Full study paper available to download as PDF at: Article Detail - International Journal of Advanced Research


A Google search for "mitral valve iron" shows up multiple studies that show iron deficiency as an independent predictor for mitral valve regurgitation, and that it is common in patients who suffer from valvular heart disease and patients who undergo cardiac valve replacement:

The association of functional mitral regurgitation and anemia in patients with non-ischemic dilated cardiomyopathy. - PubMed - NCBI

[Iron deficiency following implantation of a heart valve prosthesis]. - PubMed - NCBI

[Anemia in patients with artificial heart valves (author's transl)]. - PubMed - NCBI

Traumatic Hemolysis with Iron Deficiency Anemia in Patients with Aortic Valve Lesions | Annals of Internal Medicine | American College of Physicians

Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis

[Investigations of iron and folate levels in serum after implantation of heart valve prostheses (author's transl)]. - PubMed - NCBI

[Haemolysis after heart valve replacement (author's transl)]. - PubMed - NCBI


A Google search for "heart disease iron" comes up with a lot of studies including:

Iron deficiency and heart disease: ironclad evidence? - PubMed - NCBI

Anemia in chronic heart failure: can we treat? What to treat? - PubMed - NCBI

Anemia and iron deficiency in heart failure. - PubMed - NCBI

Low iron levels linked with increased risk of heart disease

[Anaemia in chronic heart failure]. - PubMed - NCBI

[Diagnosis and treatment of anemia in heart failure patients]. - PubMed - NCBI

Recognition and treatment of anemia in the setting of heart failure due to systolic left ventricular dysfunction. - PubMed - NCBI

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.030099#


So all in all, I think antipsychotic drugs can cause iron deficiency anemia, which impairs/decreases dopamine metabolism/production, which in part causes heart disease like heart failure.

First off, none of those studies under heart failure even measured an iron marker, so I don't know how they can claim that "iron deficiency" is a factor. On the contrary, it's usually high (or so called "high normal") body iron stores that go along with, and are likely causal, in heart disease. This is the claim of Jerome Sullivan's Iron Hypothesis, which is based on the fact that teenagers and pre-menopausal women have the lowest rates of heart disease, and also the lowest stores of body iron. It's a shame this article wasn't the first result when you googled "heart disease iron" - Jerome L. Sullivan, father of the iron hypothesis of heart disease - Rogue Health and Fitness

The link "low iron levels linked with disease" not only isn't an actual study (more like a press release), and they predicted body iron levels through "genomic data." No idea how that can be in any way accurate.

While haloperidol may cause anemia, it certainly doesn't seem to be iron deficiency anemia, as, according to the study, "The serum ferritin and iron levels in these patients were within the normal range." There are all sorts of things that can cause anemia in people with normal or even high body iron levels. Deficiencies of B Vitamins, like B6, B12, and folate are very common, and often overlooked. More serious conditions like Sickle Cell and Thalassemia are other types of anemias.

This may indeed be another type of anemia (call it "Haloperidol Induced Anemia"), but it certainly isn't accurate to call it iron deficiency anemia.
 
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TreasureVibe

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First off, none of those studies under heart failure even measured an iron marker, so I don't know how they can claim that "iron deficiency" is a factor. On the contrary, it's usually high (or so called "high normal") body iron stores that go along with, and are likely causal, in heart disease. This is the claim of Jerome Sullivan's Iron Hypothesis, which is based on the fact that teenagers and pre-menopausal women have the lowest rates of heart disease, and also the lowest stores of body iron. It's a shame this article wasn't the first result when you googled "heart disease iron" - Jerome L. Sullivan, father of the iron hypothesis of heart disease - Rogue Health and Fitness

The link "low iron levels linked with disease" not only isn't an actual study (more like a press release), and they predicted body iron levels through "genomic data." No idea how that can be in any way accurate.

While haloperidol may cause anemia, it certainly doesn't seem to be iron deficiency anemia, as, according to the study, "The serum ferritin and iron levels in these patients were within the normal range." There are all sorts of things that can cause anemia in people with normal or even high body iron levels. Deficiencies of B Vitamins, like B6, B12, and folate are very common, and often overlooked. More serious conditions like Sickle Cell and Thalassemia are other types of anemias.

This may indeed be another type of anemia (call it "Haloperidol Induced Anemia"), but it certainly isn't accurate to call it iron deficiency anemia.
There's a difference in body iron stores, free iron and bound iron.
 
Last edited:

tankasnowgod

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There's a difference in body iron stores, free iron and bound iron.

Sure. But this doesn't change any of my points, or the fact that anemias that happen when body iron stores are normal or high are in no way "iron deficiency anemia." If you accept that there is a difference in those three, certainly you can accept that there is a difference with the many established forms of anemia.

Of note, I believe what you are referring to as "free iron" is serum iron, which is usually bound to transferrin. TSAT is simply a calculation of serum iron divided by TIBC. While iron can be "free" or unbound in blood and other bodily fluids, it will absolutely wreck havoc, which is why all body fluids (except urine) have large amounts of either transferrin or lactoferrin, to capture any unbound iron. Urine relies on the flushing action to keep sterile.
 
Last edited:

tankasnowgod

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Attached is the table from the original study.

Absolutely no marker suggests "Iron Deficiency" in ANY of the groups, not even the ferritin levels of 22-27 in the clozapine group, although that would certainly be considered "borderline low" by most lab ranges. A ferritin level of 90 isn't considered "low" by any range or iron researcher. The very high TSAT levels in all groups certainly suggest that iron excess is indeed a factor in schizophrenia. Regardless, with a ferritin of 90 and TSAT of 40%, a very low TIBC (inversely correlated with iron stores), no honest researcher would conclude "Iron Deficiency" is at a factor in the Haloperidol group.
 

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