Effects of Neuroleptic Treatments on Peripheral Opioid Secretion

Brambilla, Frăncesca; Facchinetti, Fabio; Smeraldi, Enrico; Bellodi, Laura; Brancato,; Genazzani, Ar

doi:10.1159/000118395

Cited by 6 publications

(4 citation statements)

References 20 publications

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“…Endorphin levels increased only in patients under long-term antipsychotic treatment. 16 In our previous study, we found that inpatients during relapse of illness with predominant negative symptoms had higher BE concentrations than those with acute positive symptoms and healthy controls. 9 Effective treatment resulted in a decrease in the final BE concentration to a level similar to that in healthy controls, despite the use of various individually tailored drugs.…”

Section: Discussionmentioning

confidence: 79%

<p>The Relationship Between Course of Illness and β-Endorphin Plasma Levels in Patients with Schizophrenia</p>

Urban-Kowalczyk

Kotlicka-Antczak

Strzelecki

et al. 2020

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Objective: Extensive investigations have been conducted into predictors of schizophrenia outcome. The heterogeneity of the illness implies that many factors should be taken into account. Some studies have reported the relationship between increased β-endorphin concentration and predominant negative symptoms. Methods: We included 77 outpatients with schizophrenia and 74 healthy controls. Data referring to duration and course of illness, hospitalization number and treatment were collected on the basis of clinical interviews and medical documentation analysis. The β-endorphin concentrations were assessed once in all participants, at the onset of the study. Results: A chronic course of illness was found in 44 of the 77 schizophrenics. Patients with schizophrenia, especially those with a chronic course of illness, revealed significantly higher β-endorphin concentrations than those with an episodic course and controls (mean 29.70 vs 19.86 pmol/L; p=0.0001). Increased levels of β-endorphin were related to longer duration of illness (R=0.294, p=0.009) and frequent psychiatric hospitalization (R=0.346, p=-0.002). Conclusion: Endorphins may be potential biological predictors of persistent negative symptoms and final outcome in schizophrenia.

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Section: Discussionmentioning

confidence: 79%

<p>The Relationship Between Course of Illness and β-Endorphin Plasma Levels in Patients with Schizophrenia</p>

Urban-Kowalczyk

Kotlicka-Antczak

Strzelecki

et al. 2020

NDT

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“…In line with these observations increased basal BE concentrations were observed among pharmacologically treated individuals with chronic schizophrenia. 32 Endorphin level was found to increase only in patients under long-term antipsychotic treatment. Mauri et al, 17 assessed neuropeptide concentrations in peripheral blood mononuclear cells at baseline in 30 drug-naïve schizophrenic patients; however, second assessment was performed four weeks later, among only nine haloperidol-treated individuals.…”

Section: Discussionmentioning

confidence: 95%

The Relationship Between Antipsychotic Treatment and Plasma β-Endorphin Concentration in Patients with Schizophrenia

Urban-Kowalczyk

Kotlicka-Antczak

Strzelecki

et al. 2021

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Objective Some studies indicate the presence of elevated opioid levels in cases of schizophrenia and their relationship with negative symptoms. The pathogenesis of schizophrenia may be associated with an imbalance in the modulatory effect of opioids on the dopaminergic system. The aim of the study was to identify the association between β-endorphin (BE) concentration and the outcome of short-term schizophrenia treatment. Methods We examined 49 patients hospitalized due to exacerbation of schizophrenia symptoms and 47 controls without schizophrenia. The severity of psychopathological symptoms was evaluated using Positive and Negative Syndrome Scale (PANSS) at the onset of hospitalization, and after four, six and ten weeks of treatment. Patients were classified into negative (NEG) and mixed (M) psychopathological subtypes according to the PANSS composite index. Β-endorphin (BE) plasma concentrations were assessed in all participants; in patients on inclusion to the study and after six weeks of treatment. Results The patients with schizophrenia demonstrated higher BE levels than controls. During six-week antipsychotic treatment, BE concentration significantly increased in both NEG (p=0.000) and M (p=0.007), and positive symptoms were effectively reduced. In the NEG group, the prevalence of negative symptoms decreased only transiently and returned to approximately baseline values after 10 weeks (p=0.268). In the M patients, the prevalence of negative symptoms increased gradually (p=0.001), with more severe positive and, notably, negative symptoms correlating with higher BE2 concentrations at the 10-week assessment (R= 0.47, p= 0.0135 vs R= 0.74, p=0.0000). In both NEG and M, a greater rise in BE2 level correlated with a lower composite index during treatment. Conclusion Patients with schizophrenia demonstrate higher BE levels compared to controls. These changes in BE concentration during antipsychotic treatment could reflect the interaction between dopaminergic transmission and endogenous opioids. A rise in BE level following effective antipsychotic therapy could be a potential predictor of persisting negative symptoms.

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“…Opioids have frequently been suggested as being involved in the pathophysiology of psychiatric diseases. In schizophrenic patients, elevated levels of betaendorphin and an instability of its secretion were detected (Brambilla et al 1987;Davis et al 1982;Gil-Ad et al 1986;Panza et al 1992;Pickar et al 1982;Wolkowitz et al 1986). This parallel might underline the importance of the set of experiments presented in shedding light on altered pain sensitivity in schizophrenia.…”

Section: Discussionmentioning

confidence: 99%