Ghrelin Plasma Levels during Psychopharmacological Treatment

Abstract

The mechanisms underlying weight gain induced by psychopharmacological agents are poorly understood. Because the recently discovered enteric hormone, ghrelin, stimulates food intake, we hypothesized that increases in circulating ghrelin levels might mediate the weight gain caused by certain antidepressants and atypical antipsychotic drugs. Fifty-two patients receiving psychopharmacological treatments were included in the study: 16 patients received antidepressants that are not known to induce weight gain, and 13 patients received mirtazapine or trimipramine, which are antidepressants known to lead to weight gain; 6 patients received clozapine and olanzapine, which have the highest liability among the antipsychotics to cause weight gain, and 17 patients received other antipsychotics. Fasting venous blood samples for the measurement of ghrelin were drawn in the morning between 06:00 and 08:00 a.m. in the second week of treatment. Although psychopharmacological treatment induced significant weight changes in the expected directions (most prominent in the clozapine or olanzapine treatment group), ghrelin levels did not differ significantly between groups. Psychotropic drugs with different propensities to induce body weight gain are associated with similar concentrations of plasma ghrelin in psychiatric patients after a short period of treatment.

The role of ghrelin signalling in second-generation antipsychotic-induced weight gain

“…In fact, the sensitivity of female rodents to the weight gain side-effect of SGAs over males is comparable to that in the clinic . However, only one human study has reported on gender differences in ghrelin levels under SGA treatments, but this study showed no gender effect (Himmerich et al, 2005). In contrast, one recent rodent study reported that plasma ghrelin levels were reduced by olanzapine in females but not in males (Davey et al, 2012).…”

“…One study investigated the effect of olanzapine, clozapine, antidepressants with weight gain, other antipsychotics, and other antidepressants on circulating ghrelin levels showed that after 8-14 days of treatment, there was no significant difference in circulating total ghrelin levels amongst treatment groups (Himmerich et al, 2005). Other short-to mid-term studies suggested that circulating total ghrelin levels are decreased compared to the baseline or control after 2-6 weeks of SGA treatments (Basoglu et al, 2010;Roerig et al, 2008;Tanaka et al, 2008;Vidarsdottir et al, 2010).…”

“…Further, different antipsychotics can have diverse effects on ghrelin secretion. For example, clozapine tend to have no effect on ghrelin levels in the short-term (Himmerich et al, 2005;Popovic et al, 2007;Theisen et al, 2005), and risperidone tend to increase ghrelin levels in the long-term (Esen-Danaci et al, 2008;Murashita et al, 2005;Palik et al, 2005;Perez-Iglesias et al, 2008). Moreover, differing patient hormonal states (other than ghrelin) may also affect ghrelin production.…”

Short-term treatment with olanzapine does not modulate gut hormone secretion: olanzapine disintegrating versus standard tablets

“…Earlier studies have shown that long-term treatment with olanzapine is accompanied by elevated plasma ghrelin concentrations (24,25). In contrast, ghrelin concentrations were either not affected (26,27) or decreased (28, 29) by short-term treatment (2-10 weeks) with olanzapine. Unfortunately, in the shortterm studies, the number of participants was small, participants were of both sexes, and hormonal status of premenopausal women was not taken into account.…”

Food Intake and Reward Mechanisms in Patients with Schizophrenia: Implications for Metabolic Disturbances and Treatment with Second-Generation Antipsychotic Agents

“…Increases (Murashita et al, 2005;Palik et al, 2005), decreases (Togo et al, 2004), and no change (Sporn et al, 2005;Theisen et al, 2005;Himmerich et al, 2005) in plasma ghrelin levels were reported in patients treated with SGAs; a consensus regarding clinical significance of these changes has not yet transpired. Likewise, potential contributions to weight gain of norepinephrine (Elman et al, 2002(Elman et al, , 2004 and prolactin (Melkersson, 2005;Mann et al, 2006) increases associated with SGA treatment are still unclear.…”