Drug Res (Stuttg) 2013; 63(08): 424-428
DOI: 10.1055/s-0033-1343494
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Determination of Serum Antioxidant Vitamins, Glutathione and MDA Levels in Panic Disorder Patients

Z. Nahar
1   Department of Clinical Pharmacy and Pharmacology, University of Dhaka, Dhaka, Bangladesh
M. S. Sarwar
2   Department of Pharmacy, Noakhali Science and Technology University, Noakhali, Bangladesh
M. Safiqul Islam
2   Department of Pharmacy, Noakhali Science and Technology University, Noakhali, Bangladesh
A. Rahman
3   Centre for Advanced Research in Sciences, University of Dhaka, Dhaka, Bangladesh
S. Nazrul Islam
4   Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
M. S. Islam
1   Department of Clinical Pharmacy and Pharmacology, University of Dhaka, Dhaka, Bangladesh
A. Hasnat
1   Department of Clinical Pharmacy and Pharmacology, University of Dhaka, Dhaka, Bangladesh
› Author Affiliations
Further Information

Publication History

received 17 February 2013

accepted 09 April 2013

Publication Date:
13 May 2013 (online)


There are sufficient experimental evidences to establish the relationship between the elevated level of malondealdehyde (MDA)–the lipid peroxidation product and depleted level of antioxidants (Vitamin A, E, C and glutathione) in several psychiatric disorders. But previously no study was carried out to determine these components in panic disorder (PD) patients of Bangladesh. This study was conducted to assess the serum concentration of antioxidant vitamins, MDA and glutathione in 54 panic disorder patients and 52 healthy volunteers. Patients were recruited from Bangabandhu Sheikh Mujib Medical University, Bangladesh by random sampling. Serum level of MDA, glutathione and vitamin C were determined by UV spectrophotometric method whereas Vitamins A and E were detected by RP-HPLC method. Data were analyzed by independent t test and Pearson’s correlation analysis. It had been found that the PD patients had low level of antioxidants like vitamin A (p=0.041) and vitamin E (p=0.018) than the healthy controls whereas the change of vitamin C is not significant. It had been found that the MDA content was significantly higher (p<0.05) in PD patients than that of controls. There was no significant difference for the glutathione content between the 2 groups. Pearson’s correlation coefficient suggested that there were significant negative correlation between the glutathione level and vitamin C (p=0.013) and a positive correlation between the vitamin E and vitamin A (p=0.020) in patient group. Our study reveals that panic disorder patients have considerably higher level of MDA, lower level of antioxidant vitamins and glutathione than the healthy control subjects.

  • References

  • 1 Reed V, Witt-chen HU. DSM – IV Panic attacks and panic disorder in a community sample of adolescents and young adults: how specific are panic attacks?. Journal of Psychiatric Research 1998; 32: 335-345
  • 2 Regier DA, Rae D, Narrow WE et al. Prevalence of anxiety disorders and their comorbidity with mood and addictive disorders. British Journal of Psychiatry 1998; 34: 24-28
  • 3 Kushner MG, Sher KJ, Beitman BD. The relation between alcohol problems and the anxiety disorders. American Journal of Psychiatry 1990; 147: 685-695
  • 4 Baillir AJ, Rapee RM. Panic attacks as a risk markers for mental disorder. Journal of the American Academy of Child and Adolescent Psychiatry 2005; 40: 240-244
  • 5 Goodwin RD, Hamilton SP. Panic attack as a marker of core psychopathological processes. Psychopathology 2001; 34: 278-288
  • 6 Goodwin RD, Liel R, Hoefler M et al. Panic attack as a risk factor for severe psychopathology. American Journal of Psychiatry 2004; 161: 2207-2214
  • 7 Masi G, Mucci M, Millepiede S. Separation anxiety in children and adolescent: epidemiology diagnosis and management. CNS Drugs 2001; 15: 93-104
  • 8 Masi G, Millepiede S, Mucci M et al. Generalized anxiety disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 2004; 43: 752-760
  • 9 Kaufman J, Charney D. Comorbidity of mood and anxiety disorders. Depress Anxiety 2000; 12: 69-76
  • 10 Masi G, Millepiede S, Mucci M et al. A naturalistic study of reffered children and adolescents with obsessive compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry 2005; 44: 673-681
  • 11 Goodwin RD, Fergusson DM, Horwood LJ. Panic attacks and the risk of depression among young adults in the community. Psychiatry and Psychosomatics 2004; 73: 158-265
  • 12 Masi G, Tom C, Perugi G et al. Anxiety comorbidiy in conequitively refered children and adolescents with bipolar disorder. A neglected comorbidity. Canadian Journal of Psychiatry 2001; 46: 766-771
  • 13 Gorman JM, Coplan JD. Comorbidity of depression and panic disorder. Journal of Clinical Psychiatry 1996; 10: 34-41
  • 14 Berr C, Richard MJ, Gourlet V et al. Enzymatic antioxidant balance and cognitive decline in aging – the EVA study. European Journal of Epidemiology 2004; 19: 133-138
  • 15 Meydani M. Antioxidants and cognitive function. Nutrition Reviews 2001; 59: S75-S80
  • 16 Matés JM, Pérez-Gómez C, Núñez-de-Castro I. Antioxidant enzymes and human diseases. Clinical Biochemistry 1999; 32: 595-603
  • 17 Palmer AM, Burns MA. Selective increase in lipid peroxidation in the inferior temporal cortex in Alzheimer’s disease. Brain Research 1994; 645: 338-342
  • 18 Sigalov AB, Stern LJ. Enzymatic repair of oxidative damage to human apolipoprotein A-I. FEBS Letters 1998; 433: 196-200
  • 19 Saito A, Maier CM, Narasimhan P et al. Oxidative stress and neuronal death/survival signaling in cerebral ischemia. Molecular Neurobiology 2005; 31: 105-116
  • 20 Ozcankaya R, Delibas N. Malondialdehyde, superoxide dismutase, melatonin, iron, copper, and zinc blood concentrations in patientswith Alzheimer disease: cross-sectional study. Croatian Medical Journal 2002; 43: 28-32
  • 21 Aksenov MY, Aksenova MV, Butterfield DA et al. Protein oxidation in the brain in Alzheimer’s disease. Neuroscience 2001; 103: 373-383
  • 22 Pastore A, Piemonte F, Locatelli M et al. Determination of blood total, reduced, and oxidized glutathione in pediatric subjects. Clinical Chemistry 2003; 47: 1467-1469
  • 23 Scholz RW, Graham KS, Gumpricht E et al. Mechanism of interaction of vitamin E and glutathione in the protection against membrane lipid peroxidation. Annals of the New York Academy of Sciences 1989; 570: 514-517
  • 24 Bernheim F, Berheim MLC, Wilbur KM. The reaction between thiobarbituric acid and the oxidation product of certain lipids. Journal of Biological Chemistry 1948; 174: 257-264
  • 25 Diczfalusy U, Falardeau P, Hammarstorm S. Conversion of prostaglandin endoperoxides to C17 – hydroxyacids catalyzed by human platelet thromboxane synthase. FEBS Letters 1977; 84: 271-274
  • 26 Hamberg M, Samuelsson B. Oxygenation of unsaturated fatty acids by the vesicular glands of sheep. Journal of Biological Chemistry 1967; 242: 5344-5354
  • 27 Torun M, Yardım S, Gönenç A et al. Çeşitli kanser vakalarında serum MDA düzeyleri. Turkish journal of biochemistry 1995; 20: 1-7
  • 28 Draper H, McGirr LG, Hadley M. The metabolism of malondialdehyde. Lipids 1986; 21: 305-307
  • 29 Dadheech G, Mishra S, Gautam S et al. Oxidative stress, α-tocopherol, ascorbic acid and reduced glutathione status in schizophrenics. Indian Journal of Clinical Biochemistry 2006; 21: 34-38
  • 30 Dakhale GN, Khanzode SD, Khanzode SS et al. Supplementation of vitamin C with atypical antipsychotics reduces oxidative stress and improves the outcome of schizophrenia. Psychopharmacology 2005; 182: 494-498
  • 31 Sivrioglu EY, Kirli S, Sipahioglu D et al. The impact of omega-3 fatty acids, vitamins E and C supplementation on treatment outcome and side effects in schizophrenia patients treated with haloperidol: an open-label pilot study. Progress in Neuropsychopharmacology and Biological Psychiatry 2007; 31: 1493-1499
  • 32 Maes M, De-Vos N, Pioli R et al. Lower serum Vitamin E concentrations in major depression: Another marker of lowered antioxidant defenses in that illness. Journal of Affective Disorder 2000; 58: 241-246
  • 33 Miljevic CD, Nikolic A, Damjanovlc A et al. Vitamin C and vitamin E In schizo-phrenic patients. Biological Psychiatry 1997; 42: 15-2975
  • 34 Rinaldi P, Polidori MC, Metastasio A et al. Plasma antioxi-dants are similarly depleted in mild cogntitiveim-pairment and in Alzheimer’s disease. Neurobiology of Aging 2003; 24: 915-919
  • 35 Smith MA, Rottkamp CA, Nunomura A et al. Oxidative stress in Alzheimer’s disease. Biochimica et Biophysica Acta 2000; 1502: 139-144
  • 36 Altuntas I, Aksoy H, Coskun I et al. Erythrocyte Superoxide Dismutase and Glutathione Peroxidase Activities, and Malondialdehyde and Reduced Glutathione Levels in Schizophrenic Patients. Clinical Chemistry and Laboratory Medicine 2000; 38: 1277-1281
  • 37 Atmaca M, Kuloglu M, Tezcan E et al. Antioxidant enzyme and malondialdehyde levels in patients with social phobia. Psychiatry Research 2008; 159: 95-100
  • 38 Bieri JG, Tolliver TG, Contingent GL. Simultaneous determination of α-tocopherol and retinol in plasma or red cells by HPLC. American Journal of Clinical Nutrition 1979; 32: 2143-2149
  • 39 Nazrul Islam SK, Jahangir Hossain K, Ahsan M. Serum vitamin E, C and A status of the drug addicts undergoing detoxification: influence of drug habit, sexual practice and lifestyle factors. Eur J Clin Nutr 2001; 55: 1022-1027
  • 40 Ellman GL. Tissue sulfhydryl groups. Archives of Biochemistry and Biophysics 1959; 82: 70-77
  • 41 Halliwell B, Gutteridge JMC. Oxygen free radicals and iron in relation to biology and medicine: some problems and concepts. Archives of Biochemistry and Biophysics 1986; 246: 501-514
  • 42 Halliwell B. Free radicals, antioxidants, and human disease: Curiosity, cause or consequence?. Lancet 1994; 344: 721-724
  • 43 Kartha VN, Krishnamurthy S. Antioxidant function of vitamin A. International Journal for Vitamin and Nutrition Research 1977; 47: 394-401
  • 44 Ricciarelli R, Argellati F, Pronzato MA et al. Vitamin E and neurodegenerative diseases. Molecular Aspects of Medicine 2007; 28: 591-606
  • 45 Devi U, Chinnaswamy P. Oxidative injury and enzymic antioxidant misbalance in schizophrenics with positive, negative and cognitive symptoms. African Journal of Biochemistry Research 2008; 2: 92-97
  • 46 Gautam M, Agrawal M, Gautam M et al. Role of antioxidants in generalised anxiety disorder and depression. Indian Journal of Psychiatry 2012; 54: 244-247
  • 47 Gawryluk JW, Wang JF, Andreazza AC et al. Decreased levels of glutathione, the major brain antioxidant, in post-mortem prefrontal cortex from patients with psychiatric disorders. International Journal of Neuropsychopharmacology 2011; 14: 123-130
  • 48 Tang V, Wang J. Oxidative Stress in Bipolar Disorder. Biochemistry and Analytical Biochemistry 2012; S2-002
  • 49 Ersan S, Bakir S, Ersan E et al. Examination of free radical metabolism and antioxidant defence system elements in patients with OCD. Progress in Neuro-Psychopharmacology and Biological Psychiatry 2006; 30: 1039-1042
  • 50 Kuloglu M, Atmaca M, Tezcan E et al. Antioxidant enzyme and malondialdehyde levels in patients with panic disorder. Neuropsychobiology 2002; 46: 186-189
  • 51 Behl A, Swami G, Sircar SS et al. Corre-lation between lipid peroxidation-induced TBARS level and disease severity in obsessive – compulsive disorder. Neuropsychobiology 2010; 61: 210-214
  • 52 Selek S, Herken H, Bulut M et al. Oxidative imbalance in obsessive–compulsive disorder patients: a total evaluation of oxidant–antioxidant status. Progress in Neuro-Psychopharmacology and Biological Psychiatry 2008; 32: 487-491
  • 53 Shohag MH, Ullah MA, Azad MA et al. Serum Antioxidant Vitamins and Malondialdehyde Levels in Patients with Obsessive-Compulsive Disorder. German Journal of Psychiatry 2012; 15: 10-14
  • 54 Kuloglu M, Atmaca M, Tezcan E et al. Antioxidant enzyme activities and malondialdehyde levels in patients with obsessive-compulsive disorder. Neuropsychobiology 2002; 46: 27-32
  • 55 Zhang XY, Tan YL, Cao LY et al. Antioxidant enzymes and lipid peroxidation in different forms of schizophrenia treated with typical and atypical antipsychotics. Schizophrenia Research 2006; 81: 291-300
  • 56 Bal N, Acar ST, Yazıcı A et al. Altered levels of malondialdehyde and vitamin E in major depressive disorder and generalized anxiety disorder. Düşünen Adam 2012; 25: 206-211
  • 57 Machlin LJ, Bendich A. Free radical tissue-damage: protective role of antioxidant nutrients. FASEB Journal 1987; 1: 441-445
  • 58 Berk M, Copolov DL, Dean O et al. N-Acetyl Cysteine for Depressive Symptoms in Bipolar Disorder — A Double-Blind Randomized Placebo-Controlled Trial. Biological Psychiatry 2008; 64: 468-475
  • 59 Khanna RS, Negi R, Pande D et al. Markers of Oxidative Stress in Generalized Anxiety Psychiatric Disorder: Therapeutic Implications. Journal of Stress Physiology & Biochemistry 2012; 8: 32-38
  • 60 Shulman RG, Rothman DL, Behar KL et al. Energetic basis of brain activity: implications for neuroimaging. Trends Neurosci 2004; 27: 489-495