Neuroendocrine Stress System in Bipolar Disorder

Juruena, Mário F.; Cleare, Anthony J.; Young, Allan H.

doi:10.1007/7854_2020_184

Cited by 6 publications

(2 citation statements)

References 102 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many psychiatric disturbances including bipolar disorder are deeply affected by the activity of the HPA axis, and at the same time, they also have a reciprocal effect on this neuroendocrine system (Trinetti et al., 2021). Based on growing evidence, an important part of the underlying psychopathology of bipolar disorder may be seen in persistent malfunction in the expression and role of mineralocorticoid and glucocorticoid receptors in the hippocampus, which mediates the effects of glucocorticoids in the form of negative feedback binding and is in a clear connection with the impact of stressful life events on the HPA axis (Juruena et al., 2021). Chronic stress mediated by the HPA axis—the subsequent increase in ACTH serum levels—may be related to the pathophysiology of bipolar disorder and especially manic symptoms (direct relationship between ACTH levels and manic symptoms) (Zhang et al., 2022).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of spironolactone as adjunctive therapy to sodium valproate in bipolar‐I disorder: A double‐blind, randomized, placebo‐controlled clinical trial

Zandifar,

Badrfam,

Gholamian

et al. 2023

Brain and Behavior

View full text Add to dashboard Cite

IntroductionTreatment of mood and cognitive symptoms of patients with bipolar disorder is associated with many complications and is generally not associated with therapeutic satisfaction. In this clinical trial, we evaluated the effectiveness of spironolactone in controlling mood and cognitive symptoms, sleep quality, appetite, and body mass index in patients with bipolar disorder in manic episodes.MethodsSixty inpatients with bipolar disorder in manic episodes were treated with spironolactone/placebo in an 8‐week randomized, double‐blind, placebo‐controlled clinical trial. They were evaluated using the Young Mania Rating Scale (YMRS), mini‐mental state examination (MMSE), Pittsburgh sleep quality index, Simplified Nutritional Appetite Questionnaire, and body mass index in weeks 1, 4, and 8.ResultsFor cognitive impairment (MMSE), there were significant interaction effects of group and time at week 8 (B = −1.60, SE = 0.69, t = −2.33, p = .021) such that individuals in the spironolactone group experienced more improvement in their cognitive performance. For manic symptoms (YMRS), there were no significant interaction effects of group and time at week 8 (B = −2.53, SE = 1.46, t = −1.73, p = .085).ConclusionsConsidering the promising findings in this clinical trial, further study of spironolactone as adjunctive therapy in bipolar disorder in manic episodes with larger sample sizes, multicenter settings, and longer follow‐ups are recommended.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy of spironolactone as adjunctive therapy to sodium valproate in bipolar‐I disorder: A double‐blind, randomized, placebo‐controlled clinical trial

Zandifar,

Badrfam,

Gholamian

et al. 2023

Brain and Behavior

View full text Add to dashboard Cite

show abstract

“… 78 Excessive HPA axis activity is also a feature of bipolar disorder, 79 with more robust hyperactivity observed in patients with severe manic symptoms 80 or a history of suicidal behavior. 81 In schizophrenia, changes in hair cortisol concentration are negatively associated with delusion severity, and evidence supports the use of measures of HPA axis activity as biomarkers for associated brain tissue loss. 82 , 83 A dysregulated HPA axis response to stress is associated with anorexia and bulimia nervosa and is exacerbated by the added experience of childhood trauma.…”

Section: Hpa Axis Impairment In Depression Neuropsychiatric Disorders...mentioning

confidence: 95%

Targeting the Arginine Vasopressin V1b Receptor System and Stress Response in Depression and Other Neuropsychiatric Disorders

Kanes¹,

Dennie²,

Perera³

2023

NDT

View full text Add to dashboard Cite

A healthy stress response is critical for good mental and overall health and promotes neuronal growth and adaptation, but the intricately balanced biological mechanisms that facilitate a stress response can also result in predisposition to disease when that equilibrium is disrupted. The hypothalamic-pituitary-adrenal (HPA) axis neuroendocrine system plays a critical role in the body’s response and adaptation to stress, and vasopressinergic regulation of the HPA axis is critical to maintaining system responsiveness during chronic stress. However, exposure to repeated or excessive physical or emotional stress or trauma can shift the body’s stress response equilibrium to a “new normal” underpinned by enduring changes in HPA axis function. Exposure to early life stress due to adverse childhood experiences can also lead to lasting neurobiological changes, including in HPA axis function. HPA axis impairment in patients with depression is considered among the most reliable findings in biological psychiatry, and chronic stress has been shown to play a major role in the pathogenesis and onset of depression and other neuropsychiatric disorders. Modulating HPA axis activity, for example via targeted antagonism of the vasopressin V 1b receptor, is a promising approach for patients with depression and other neuropsychiatric disorders associated with HPA axis impairment. Despite favorable preclinical indications in animal models, demonstration of clinical efficacy for the treatment of depressive disorders by targeting HPA axis dysfunction has been challenging, possibly due to the heterogeneity and syndromal nature of depressive disorders. Measures of HPA axis function, such as elevated cortisol levels, may be useful biomarkers for identifying patients who may benefit from treatments that modulate HPA axis activity. Utilizing clinical biomarkers to identify subsets of patients with impaired HPA axis function who may benefit is a promising next step in fine-tuning HPA axis activity via targeted antagonism of the V 1b receptor.

show abstract

Decreased serum allopregnanolone and progesterone levels in male patients with bipolar disorder and their effects on cognitive functions

Karademir

Beyazyüz

et al. 2023

Eur Arch Psychiatry Clin Neurosci

View full text Add to dashboard Cite

Neuroendocrine Stress System in Bipolar Disorder

Cited by 6 publications

References 102 publications

Efficacy of spironolactone as adjunctive therapy to sodium valproate in bipolar‐I disorder: A double‐blind, randomized, placebo‐controlled clinical trial

Efficacy of spironolactone as adjunctive therapy to sodium valproate in bipolar‐I disorder: A double‐blind, randomized, placebo‐controlled clinical trial

Targeting the Arginine Vasopressin V1b Receptor System and Stress Response in Depression and Other Neuropsychiatric Disorders

Decreased serum allopregnanolone and progesterone levels in male patients with bipolar disorder and their effects on cognitive functions

Contact Info

Product

Resources

About