Title: The Effect of Vitamin D Supplementation on Clinical, Electroencephalographic, and Metabolic

Outcomes in Schizophrenia Patients Under Clozapine Treatment: A Hospital-Based Controlled Study

Researcher: Dr. Bipin Kumar Yadav Guide: Dr. Umesh S. Institution: Central Institute of Psychiatry, Ranchi, Jharkhand

Background: Schizophrenia is a chronic psychiatric disorder marked by significant cognitive and functional impairments. Clozapine remains the gold standard for treatment-resistant schizophrenia but is associated with persistent symptoms and adverse metabolic effects. Recent evidence indicates that vitamin D deficiency is prevalent among schizophrenia patients and may contribute to poor cognitive, metabolic, and neurophysiological outcomes.

Rationale: Vitamin D plays a crucial neuroprotective role by regulating NMDA receptor activity and reducing pro-inflammatory cytokines. Its deficiency may exacerbate cognitive impairment, metabolic dysfunction, and seizure susceptibility in patients on clozapine. However, there is limited research evaluating vitamin D supplementation as an adjunctive therapy in this population.

Aim: To assess the impact of weekly vitamin D supplementation (60,000 IU) on clinical, metabolic, and EEG parameters in schizophrenia patients with vitamin D deficiency receiving clozapine therapy.

Objectives: 1. Evaluate improvement in psychotic symptoms (PANSS, CGI-S). 2. Assess changes in cognitive function (MoCA). 3. Examine metabolic indices (BMI, RBS, lipid profile). 4. Analyze EEG delta and theta power alterations. 5. Compare results between vitamin D–deficient and vitamin D–sufficient groups.

Methodology: A 4-week, hospital-based, prospective controlled study involving 40 schizophrenia inpatients (20 vitamin D deficient receiving supplementation; 20 with normal levels). Baseline and follow-up assessments were conducted using standardized rating scales, metabolic tests, and qEEG analysis. Data will be analyzed using SPSS v29 with appropriate statistical tests.

Expected Outcomes: Vitamin D supplementation is anticipated to improve clinical symptoms, enhance cognitive performance, normalize EEG activity, and reduce metabolic disturbances in clozapine-treated patients.

Significance: This study may highlight vitamin D’s potential as an effective, low-cost adjunctive therapy to improve neuropsychiatric and metabolic outcomes in treatment-resistant schizophrenia.

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Abstract: Schizophrenia is a chronic disorder characterized by cognitive and functional decline. Clozapine, although the most effective antipsychotic for treatment-resistant schizophrenia, is often associated with persistent symptoms and metabolic side effects. Emerging evidence suggests that vitamin D deficiency is common in schizophrenia and may contribute to neurocognitive and metabolic disturbances. This hospital-based, prospective controlled study aims to evaluate the effect of weekly vitamin D supplementation (60,000 IU) on clinical, metabolic, and electroencephalographic (EEG) outcomes in vitamin D–deficient schizophrenia patients on clozapine. Forty inpatients will be enrolled and divided into two groups—vitamin D–deficient patients receiving supplementation and those with normal levels. Clinical outcomes (PANSS, CGI-S), cognitive function (MoCA), metabolic parameters (BMI, RBS, lipid profile), and EEG measures (delta and theta power) will be assessed over four weeks. Data will be analyzed using SPSS. It is hypothesized that vitamin D supplementation will result in improved clinical and metabolic outcomes and favorable EEG changes. The findings may provide evidence supporting vitamin D as an adjunctive treatment in schizophrenia patients maintained on clozapine.