Hormonal Markers of Metabolic Dysregulation in Patients With Severe Mental Disorders After Olanzapine Treatment Under Real-Life Conditions

Birkenaes, Astrid B.; Birkeland, Kåre I.; Friis, Svein; Opjordsmoen, Stein; Andreassen, Ole A.

doi:10.1097/jcp.0b013e31819b95fc

Cited by 27 publications

(23 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…57 Moreover, we included only chronic male patients in this study. Since previous studies 35,58,59 have indicated gender differences in antipsychotic-induced dysmetabolism, our findings may not be readily applied on a female population. Except for the absence of gender effects, our naturalistic study design and consecutive enrollment of subjects increase the external validity of the present study.…”

Section: Discussionmentioning

confidence: 64%

“…35, 56 Yet, in a recent study, 41 fasting leptin levels were unaffected by short-term treatment with antipsychotics in healthy volunteers. In the present study, we did not find significant differences in levels of adiponectin and leptin between patients and controls.…”

Section: Discussionmentioning

confidence: 99%

“…Studies on adipose-derived hormones have indicated a reduced secretion of adiponectin 35,55 and increased levels of leptin in antipsychotic-treated patients. 35, 56 Yet, in a recent study, 41 fasting leptin levels were unaffected by short-term treatment with antipsychotics in healthy volunteers.…”

Section: Discussionmentioning

confidence: 99%

“…33 Although reaching only borderline significance, our patients' mean HOMA-IR index value was 35% higher as compared with that of the healthy controls (P = .11), and, as such, resembles a pattern of emerging insulin resistance. 26,[34][35][36][37][38] To this end, our patients exhibited significantly higher fasting and postprandial proinsulin as well as postprandial C-peptide and insulin levels compared with controls. In particular, an increased level of proinsulin is considered an indication of elevated physiological stress and a compromised pancreatic beta cell function.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Glucometabolic Hormones and Cardiovascular Risk Markers in Antipsychotic-Treated Patients

Ebdrup¹,

Knop²,

Madsen³

et al. 2014

J. Clin. Psychiatry

View full text Add to dashboard Cite

Objective: Treatment with antipsychotic drugs is widely associated with metabolic side effects such as weight gain and disturbed glucose metabolism, but the pathophysiologic mechanisms are unclear.Method: Fifty nondiabetic (fasting plasma glucose ≤ 7.0 mmol/L), antipsychotic-treated male patients (ICD-10 diagnosis code F20, F21, F22, F25, F28, or F60; mean ± SD age = 33.0 ± 6.7 years; body mass index [BMI; kg/ m 2 ] = 26.0 ± 4.7; waist circumference = 95.9 ± 13.3 cm; glycated hemoglobin A 1c [HbA 1c ] = 5.7% ± 0.3%) and 93 age-and waist circumference-matched healthy male controls (age = 33 ± 7.3 years; BMI = 26.1 ± 3.9; waist circumference = 94.6 ± 11.9 cm; HbA 1c = 5.7% ± 0.3%) participated in this cross-sectional study. Blood was sampled in the fasting state and 90 minutes after ingestion of a standardized liquid meal (2,268 kJ). The primary outcomes were glucometabolic hormones and cardiovascular risk markers. Data were collected between March 2008 and February 2010.Results: Compared to healthy controls, patients were characterized by elevated fasting levels of proinsulin, C-peptide, and glucose-dependent insulinotropic polypeptide (GIP) (P < .05) and higher postprandial levels of insulin, proinsulin, C-peptide, and GIP (P ≤ .02). Also, patients exhibited elevated plasma levels of C-reactive protein and signs of dyslipidemia. Fasting plasma levels of insulin, glucagon, glucagon-like peptide-1 (GLP-1), ghrelin, leptin, adiponectin, tumor necrosis factor-α, plasminogen activator inhibitor-1, and interleukin-6 and postprandial levels of glucagon, GLP-1, ghrelin, leptin, and adiponectin did not differ between groups. Conclusions:Presenting with an insulin resistant-like pattern, including beta cell hypersecretion and elevated GIP levels, nondiabetic antipsychotic-treated patients display emerging signs of dysmetabolism and a compromised cardiovascular risk profile. The appetite-regulating hormones GLP-1 and ghrelin appear not to be influenced by antipsychotic treatment. Our findings provide new clinical insight into the pathophysiology associated with metabolic side effects of antipsychotic treatment and put emphasis on the importance of implementing metabolic screening into psychiatric practice.Trial Registration: ClinicalTrials.gov identifier NCT00627757 Clin Psychiatry 2014;75(9):e899-e905 J

show abstract

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Glucometabolic Hormones and Cardiovascular Risk Markers in Antipsychotic-Treated Patients

Ebdrup¹,

Knop²,

Madsen³

et al. 2014

J. Clin. Psychiatry

View full text Add to dashboard Cite

show abstract

“…Adiponectin induces direct inhibition of proinflammatory pathways, including those regulated by toll-like receptors (TLRs) (Neumeier et al, 2006), via inhibition of NF-κB in several cell types (Lira et al, 2012). Hipoadiponectinemia has been found in schizophrenic patients (Hanssens et al, 2008) and antipsychotic therapy also contributes to this condition (Birkenaes et al, 2009;Oriot et al, 2008;Wampers et al, 2012), suggesting that antipsychotic medication may influence adiponectin homeostasis.…”

Section: Antipsychotics Glucose Intolerance Insulin Resistance and mentioning

confidence: 98%

Antipsychotics-induced metabolic alterations: Focus on adipose tissue and molecular mechanisms

Gonçalves¹,

Araújo²,

Martel³

2015

European Neuropsychopharmacology

View full text Add to dashboard Cite

Current Data on and Clinical Insights into the Treatment of First Episode Nonaffective Psychosis: A Comprehensive Review

Crespo‐Facorro

Pelayo-Terán²,

Son³

2016

Neurol Ther

View full text Add to dashboard Cite

Implementing the most suitable treatment strategies and making appropriate clinical decisions about individuals with a first episode of psychosis (FEP) is a complex and crucial task, with relevant impact in illness outcome. Treatment approaches in the early stages should go beyond choosing the right antipsychotic drug and should also address tractable factors influencing the risk of relapse. Effectiveness and likely metabolic and endocrine disturbances differ among second-generation antipsychotics (SGAs) and should guide the choice of the first-line treatment. Clinicians should be aware of the high risk of cardiovascular morbidity and mortality in schizophrenia patients, and therefore monitoring weight and metabolic changes across time is mandatory. Behavioral and counseling interventions might be partly effective in reducing weight gain and metabolic disturbances. Ziprasidone and aripiprazole have been described to be least commonly associated with weight gain or metabolic changes. In addition, some of the SGAs (risperidone, amisulpride, and paliperidone) have been associated with a significant increase of plasma prolactin levels. Overall, in cases of FEP, there should be a clear recommendation of using lower doses of the antipsychotic medication. If no or minimal clinical improvement is found after 2 weeks of treatment, such patients may benefit from a change or augmentation of treatment. Clinicians should provide accurate information to patients and relatives about the high risk of relapse if antipsychotics are discontinued, even if patients have been symptom free and functionally recovered on antipsychotic treatment for a lengthy period of time.

show abstract

Hormonal Markers of Metabolic Dysregulation in Patients With Severe Mental Disorders After Olanzapine Treatment Under Real-Life Conditions

Abstract: Alterations in several interrelated metabolic hormonal markers were associated with olanzapine treatment, independent of body mass, particularly in female subjects.

Cited by 27 publications

References 50 publications

Glucometabolic Hormones and Cardiovascular Risk Markers in Antipsychotic-Treated Patients

Glucometabolic Hormones and Cardiovascular Risk Markers in Antipsychotic-Treated Patients

Antipsychotics-induced metabolic alterations: Focus on adipose tissue and molecular mechanisms

Current Data on and Clinical Insights into the Treatment of First Episode Nonaffective Psychosis: A Comprehensive Review

Contact Info

Product

Resources

About