期刊
SCHIZOPHRENIA RESEARCH
卷 100, 期 1-3, 页码 70-85出版社
ELSEVIER
DOI: 10.1016/j.schres.2007.11.026
关键词
atypical antipsychotics; schizophrenia; leptin; ghrelin; adiponectin; weight gain; metabolic side effect
类别
资金
- NATIONAL INSTITUTE OF MENTAL HEALTH [R01MH071536, P30MH080002] Funding Source: NIH RePORTER
- NIMH NIH HHS [P30 MH080002, R01 MH071536, MH071536, P30 MH080002-01] Funding Source: Medline
Background: Many adverse effects of atypical antipsychotic treatment are associated with antagonism of monoamine receptors; however, data indicate that important metabolic effects, such as hypertriglyceridemia and impairment in glucose/insulin homeostasis, may not be related to these mechanisms, leading investigators to explore alternative hypotheses. Promising candidates include a possible impact of antipsychotics on peptide hormonal regulators of metabolic control such as leptin, ghrelin, and adiponectin. The purpose of this review is to summarize recent data on changes in these hormones during atypical antipsychotic treatment. Methods: A Medline search was performed for papers published from January 1999 to January 2007 using key words antipsychotic, atypical antipsychotic, and individual atypical antipsychotic drug names cross-referenced with leptin, ghrelin, and adiponectin. Results: The bulk of the published work focused on changes in body weight and serum leptin, with far less data on ghrelin, and adiponectin, and nonweight metabolic changes. Leptin changes were directly related to a medication's weight gain liability, with no added antipsychotic effects on leptin signaling. Conflicting results emerged for the other markers, but all three long-term studies on ghrelin showed increased levels in patients on atypical antipsychotics with weight gain liabilities. Conclusions: Leptin increases during antipsychotic treatment are a result of weight gain rather than a direct impact of atypical antipsychotics on leptin physiology. Preliminary long-term data show increased ghrelin levels, but this finding must be replicated. The association with antipsychotic effects on glucose and lipid metabolism and these hormones remains virtually unstudied. Future research should indicate whether ghrelin and other peptide hormones may be useful predictors of weight gain or metabolic changes in patients on antipsychotics. (C) 2007 Elsevier B.V. All rights reserved.
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