Background: Schizophrenia is a mental disorder affecting thoughts, emotions, and behavior. Antipsychotic therapy is the main treatment; however, it may cause neurological side effects, including Neuroleptic Malignant Syndrome (NMS). Creatine Phosphokinase (CPK) is commonly used as a biomarker for detecting NMS. Objective: To evaluate the relationship between the duration of antipsychotic therapy and CPK enzyme activity and to determine the cut-off value of therapy duration associated with increased CPK levels in patients with schizophrenia. Methods: This cross-sectional study used secondary data from 43 schizophrenia patients treated at the West Java Provincial Mental Hospital between January and September 2024. Samples were selected using purposive sampling. Inclusion criteria were patients receiving single or combination antipsychotic therapy, while patients with heart disease or muscle disorders were excluded. Spearman correlation analysis was used to assess the relationship between therapy duration and CPK activity, and Receiver Operating Characteristic (ROC) analysis was performed to determine the cut-off value. Results: No significant relationship was found between the duration of antipsychotic therapy and CPK enzyme activity (p = 0.311). ROC analysis identified a therapy duration cut-off at 19–20 days, although its predictive value was weak (Asymp. Sig = 0.237). Conclusion: There was no significant relationship between the duration of antipsychotic therapy and CPK enzyme activity in patients with schizophrenia. Although a therapy duration cut-off of 19–20 days was identified, further studies with larger samples are needed.
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