Quetiapine reduces nocturnal urinary cortisol excretion in healthy subjects

Cohrs, Stefan; Pohlmann, Kathrin; Guan, Zhenghua; Jordan, Wolfgang; Meier, Andreas; Huether, Gerald; Rüther, Eckart; Rodenbeck, Andrea

doi:10.1007/s00213-003-1766-6

Cited by 38 publications

(25 citation statements)

References 63 publications

(75 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These results are comparable with the effects of the atypical antipsychotic quetiapine studied under similar conditions [18], but are in contrast with the finding of unchanged cortisol secretion seen after acute administration of amisulpride in healthy subjects [19].…”

Section: Discussionsupporting

confidence: 83%

“…In this context, we also found that quetiapine, an atypical antipsychotic with predominant 5-HT2A antagonism relative to its low affinity for the 5-HT2C receptor, also decreases cortisol excretion [18]. Furthermore, the lack of influence on cortisol concentrations observed after the administration of amisulpride [19] is compatible with this mechanism of action of ziprasidone since amisulpride is a selective dopamine D2/D3 receptor blocker without significant activity at 5-HT2 receptors.…”

Section: Discussionsupporting

confidence: 58%

“…The atypical antipsychotics clozapine, olanzapine, and quetiapine, but not amisulpiride, have been shown to reduce circulating cortisol concentrations in both schizophrenic patients and healthy subjects [14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

“…Collecting nocturnal urine minimizes the potential effects of physical and mental stressors occurring during the daytime and provides a more reliable estimate of treatment differences in basal nocturnal cortisol excretion. In addition to evaluation during undisturbed sleep (night 1) subjects were studied on night 2 following exposure to an acoustic stimulus, used as a standardized psychological stressor [18].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ziprasidone decreases cortisol excretion in healthy subjects

Meier

Neumann

Jordan

et al. 2005

Brit J Clinical Pharma

Self Cite

View full text Add to dashboard Cite

Br J Clin Pharmacol AimsTo determine the influence of the atypical antipsychotic ziprasidone on cortisol excretion. MethodsIn a double-blind, placebo-controlled, randomized cross-over design 11 healthy male subjects were studied twice for 2 consecutive nights (N1, undisturbed sleep conditions; N2, exposure to acoustic stress) 5 days apart. Placebo or ziprasidone 40 mg was administered orally 2 h before bedtime on N1 and N2. Urine was collected during three fractionated collection periods (evening; night; morning) for the later determination of cortisol concentrations by standard radioimmunoassays. ResultsZiprasidone decreased the total amount of cortisol excreted by 4.9 (95% CI 3.3, 6.5) m g during N1 and by 10.8 (95% CI 5.7, 15.8) m g during N2 ( P < 0.002) . This effect was still detectable in the morning ( P < 0.02), with decreases of 5.8 (95% CI -2.8, 14.4) m g after N1 and by 12.1 (95% CI 2.8, 21.4) m g after N2 .The effect subsided in the evening. A significant intervention-condition interaction ( P < 0.02), was found. The significant increase in cortisol excretion during acoustic stress observed with placebo was absent after treatment with ziprasidone. ConclusionsThe significant decrease in nocturnal cortisol excretion following ziprasidone reflects a decreased activity of the HPA-axis in healthy subjects. This effect may be an important contributor to the mode of action of ziprasidone in different patient populations, particularly in the treatment of depression and in cognitive impairment in schizophrenia.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ziprasidone decreases cortisol excretion in healthy subjects

Meier

Neumann

Jordan

et al. 2005

Brit J Clinical Pharma

Self Cite

View full text Add to dashboard Cite

show abstract

“…Because hypercortisolemia (Cushing's syndrome) leads to insulin resistance, glucose intolerance, high blood pressure, and triglyceridemia, the authors suggested that hypercortisolemia could be the primary defect that leads to the development of the insulin resistance in antipsychotic-naive patients with schizophrenia (27). However, in studies examining the effects of antipsychotic medication on patients with schizophrenia, changes in total plasma cortisol levels have generally not been measured or have been an inconsistent finding (27,28).…”

Section: Discussionmentioning

confidence: 99%

Insulin Resistance Is Associated With Hypercortisolemia in Polynesian Patients Treated With Antipsychotic Medication

Poa¹,

Edgar²

2007

Diabetes Care

View full text Add to dashboard Cite

OBJECTIVE -Type 2 diabetes is more prevalent in the indigenous Polynesian population of New Zealand (Maori) than in Europeans. The aim of this study was to determine whether insulin resistance in Maori psychiatric patients was associated with antipsychotic treatment and to investigate the mechanism of an association.RESEARCH DESIGN AND METHODS -Thirty adult Maori psychiatric patients receiving antipsychotic medication for Ͼ6 months and 30 healthy, age-, sex-, and BMI-matched control subjects were enrolled. Early morning fasting blood samples were analyzed for plasma levels of glucose, insulin, A1C, triglycerides, total cholesterol, IGF-1, cortisol, cortisol-binding globulin (CBG), and adiponectin.RESULTS -The patient group had significantly higher median fasting insulin plasma levels than the control group (P ϭ 0.002), which were independent of BMI, age, and sex. In addition, the patient group had significantly higher total cortisol (P ϭ 0.03) and lower CBG levels (P ϭ 0.004) than the control group, resulting in significantly higher levels of free cortisol (P ϭ 0.004). The patient group was also significantly more hypoglycemic (P ϭ 0.026) and hypertriglyceridemic (P ϭ 0.028) than the control group. There was no significant difference in BMI, waist circumference, A1C, total cholesterol, IGF-1, or adiponectin levels between the two groups.CONCLUSIONS -An increase in insulin resistance is seen in Maori psychiatric patients treated with antipsychotic medication. Therefore, Polynesian ethnicity should be considered in prescribing practice and general care of this group. In addition, the hypothalamic-pituitaryadrenal axis may have an important role in the mechanism by which this insulin resistance develops.

show abstract

Hypothalamic‐Pituitary‐Adrenocortical Axis: Neuropsychiatric Aspects

Jacobson

2014

Comprehensive Physiology

132

View full text Add to dashboard Cite

Evidence of aberrant hypothalamic-pituitary-adrenocortical (HPA) activity in many psychiatric disorders, although not universal, has sparked long-standing interest in HPA hormones as biomarkers of disease or treatment response. HPA activity may be chronically elevated in melancholic depression, panic disorder, obsessive-compulsive disorder, and schizophrenia. The HPA axis may be more reactive to stress in social anxiety disorder and autism spectrum disorders. In contrast, HPA activity is more likely to be low in PTSD and atypical depression. Antidepressants are widely considered to inhibit HPA activity, although inhibition is not unanimously reported in the literature. There is evidence, also uneven, that the mood stabilizers lithium and carbamazepine have the potential to augment HPA measures, while benzodiazepines, atypical antipsychotics, and to some extent, typical antipsychotics have the potential to inhibit HPA activity. Currently, the most reliable use of HPA measures in most disorders is to predict the likelihood of relapse, although changes in HPA activity have also been proposed to play a role in the clinical benefits of psychiatric treatments. Greater attention to patient heterogeneity and more consistent approaches to assessing treatment effects on HPA function may solidify the value of HPA measures in predicting treatment response or developing novel strategies to manage psychiatric disease.

show abstract

Quetiapine reduces nocturnal urinary cortisol excretion in healthy subjects

Abstract: The significant reduction of nocturnal cortisol excretion following quetiapine reflects a decreased activity of the HPA-axis in healthy subjects. This finding may be an important aspect in quetiapine's mode of action in different patient populations.

Cited by 38 publications

References 63 publications

Ziprasidone decreases cortisol excretion in healthy subjects

Ziprasidone decreases cortisol excretion in healthy subjects

Insulin Resistance Is Associated With Hypercortisolemia in Polynesian Patients Treated With Antipsychotic Medication

Hypothalamic‐Pituitary‐Adrenocortical Axis: Neuropsychiatric Aspects

Contact Info

Product

Resources

About