Mechanism and treatments of antipsychotic-induced weight gain

Ye, Wujie; Xing, Jingyu; Yu, Zekai; Hu, Xingang; Zhao, Yan

doi:10.1038/s41366-023-01291-8

Cited by 7 publications

(3 citation statements)

References 141 publications

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“…Drug‐related hyperprolactinemia can occur through two main pathways: post‐synaptic 5‐hydroxytryptamine receptors in the hypothalamus, and indirect inhibition of tuberoinfundibular dopaminergic neurons, especially at higher dosages. These pathways, together with an imbalance of the neuroendocrine system, lead to increased appetite and reduced autonomous activities, further exacerbating adipose tissue deposition and ultimately leading to weight gain 58 . Metabolic outcomes are attributable to a multifactorial aetiology and may include increased blood glucose levels and glycosylated haemoglobin, high HOMA‐IR and metabolic syndrome 59 …”

Section: Prolactin Effects On Pancreatic β‐Cellsmentioning

confidence: 99%

Prolactin effects on the pathogenesis of diabetes mellitus

Scairati,

Auriemma,

Del Vecchio

et al. 2024

Eur J Clin Investigation

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BackgroundProlactin (PRL) is a pituitary hormone promoting lactation in response to the suckling reflex. Beyond its well‐known effects, novel tissue‐specific and metabolic functions of PRL are emerging.AimsTo dissect PRL as a critical mediator of whole‐body gluco‐insulinemic sensitivity.MethodsPubMed‐based search with the following terms ‘prolactin’, ‘glucose metabolism’, ‘type 2 diabetes mellitus’, ‘type 1 diabetes mellitus’, ‘gestational diabetes mellitus’ was performed.DiscussionThe identification of the PRL‐glucose metabolism network poses the basis for unprecedented avenues of research in the pathogenesis of diabetes mellitus type 1 or 2, as well as of gestational diabetes. In this regard, it is of timely relevance to define properly the homeostatic PRL serum levels since glucose metabolism could be influenced by the circulating amount of the hormone.ResultsThis review underscores the basic mechanisms of regulation of pancreatic β‐cell functions by PRL and provides a revision of articles which have investigated the connection between PRL unbalancing and diabetes mellitus. Future studies are needed to elucidate the burden and the role of PRL in the regulation of glucose metabolism and determine the specific PRL threshold that may impact the management of diabetes.ConclusionA careful evaluation and context‐driven interpretation of PRL levels (e.g., pregnancy, PRL‐secreting pituitary adenomas, drug‐related hyper‐ and hypoprolactinemia) could be critical for the correct screening and management of glucometabolic disorders, such as type 1 or 2 as well as gestational diabetes mellitus.

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Section: Prolactin Effects On Pancreatic β‐Cellsmentioning

confidence: 99%

Prolactin effects on the pathogenesis of diabetes mellitus

Scairati,

Auriemma,

Del Vecchio

et al. 2024

Eur J Clin Investigation

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“…There have been several recent high-quality reviews of PDWG and its treatment [1 && , [27][28][29]. This review will not attempt to summarize or replicate this but instead will focus on an important element of the pathway by which psychotropic drugs cause weight gain, namely how they change eating behaviour.…”

Section: Weight Gain Associated With Psychotropic Agentsmentioning

confidence: 99%

Psychotropic drugs, eating behaviour and weight gain

Arniotis-Streat,

Fonte,

Ziauddeen

2024

Current Opinion in Psychiatry

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Purpose of review Psychotropic drug related weight gain is a common side-effect of significant concern to both clinicians and patients. Recent studies and treatment guidelines strongly support taking preventive and early treatment approaches to psychotropic drug-related weight gain (PDWG). Arguably the main pathway that PDWG occurs is via changes in eating behaviour leading to increased caloric intake. Recent findings Systematic reviews and meta-analyses have provided good data on the nature and prevalence of alterations in eating behaviour with psychotropic treatment including increased hunger, night eating and binge eating. These changes are unsurprisingly more prominent with agents like olanzapine and clozapine that have high propensity to cause weight gain. Summary Altered eating behaviour can serve as an earlier measure of the risk of weight gain and can be examined easily in clinical practice. Detecting these changes can enable earlier action in terms of switching treatments and starting pharmacological and nonpharmacological preventive strategies.

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“…Therefore, assessing the causal association between adiposity and mental illness is challenging but is nonetheless crucial to understanding disease etiology and to develop effective diagnostic, therapeutic, and preventative interventions. Such knowledge also has major public health implications because, despite the introduction of psychological therapy and medication, many patients respond poorly to these current treatments 13,14 , and many psychotherapeutic agents increase the risk of weight gain 1516 .…”

Section: Introductionmentioning

confidence: 99%

The causal role of adiposity in mental illness: A systematic review and meta-analysis of Mendelian randomization studies

Gao,

Doody,

Koutoukidis

et al. 2024

Preprint

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Importance: Excess adiposity is associated with mental illnesses, but the causality of these associations remains equivocal. Objective: To examine the causal effect of adiposity on mental illnesses by summarizing and assessing evidence from Mendelian randomization (MR) studies. Study Selection: Searches were conducted on Embase, Medline, and Web of Science from database inception to January 8th 2024. Data Extraction and Synthesis: Studies using MR study designs that estimated adiposity measures including body mass index, abdominal adiposity, peripheral adiposity, or body composition in relation to mental illnesses were included. Study quality was assessed with a scoring system reflecting MR study guidelines. Data were pooled in meta-analyses using random-effects models. Subgroup analyses were conducted by sex. Main Outcomes and Measures: Outcomes were the presence or severity of depression, anxiety, eating disorders, bipolar disorder, obsessive compulsive disorder, post-traumatic stress disorder, schizophrenia, and related psychotic disorders. Results: Forty-one studies with 184 MR estimates were included in the systematic review; and 16 studies with 30 MR estimates were included in meta-analysis. Pooled estimates suggested that general adiposity was causally associated with depression (OR: 1.05, 95% CI, 1.00-1.10, p<0.001; I2=82.8%), though the effect size was modest and there was high heterogeneity. Subgroup difference by sex in the causal relationship was not observed (p=0.382). No evidence of causal associations was found between adiposity and other mental illnesses, though these analyses were characterized by high imprecision and heterogeneity. Conclusion and Relevance: General adiposity appears to be causally associated with depression, suggesting psychological benefits of weight management. Evidence for causal associations between adiposity and other mental illnesses remains uncertain.

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Mechanism and treatments of antipsychotic-induced weight gain

Cited by 7 publications

References 141 publications

Prolactin effects on the pathogenesis of diabetes mellitus

Prolactin effects on the pathogenesis of diabetes mellitus

Psychotropic drugs, eating behaviour and weight gain

The causal role of adiposity in mental illness: A systematic review and meta-analysis of Mendelian randomization studies

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