The effects of olanzapine and fluphenazine on plasma cortisol, prolactin and muscle rigidity in schizophrenic patients: A double blind study

Jakovljević, Miro; Pivac, Nela; Mihaljević-Peleš, Alma; Mustapić, Maja; Relja, Maja; Ljubičić, Đulijano; Marčinko, Darko; Mück‐Šeler, Dorotea

doi:10.1016/j.pnpbp.2006.10.007

Cited by 22 publications

(16 citation statements)

References 24 publications

(33 reference statements)

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“…Also, patients with schizophrenia frequently display an impaired HPA axis response following an acute stress [73–77]. Both first and second generation antipsychotics have been associated with cortisol changes in patients with psychosis, but increasing evidences suggest that second generation antipsychotics reduce cortisol to a greater extent comparing to first generation [78–80]. The study, conducted in a small sample of healthy volunteers [81], has demonstrated no effect of the haloperidol on cortisol levels, and a reduction of cortisol levels by antipsychotics like quetiapine and risperidone.…”

Section: Discussionmentioning

confidence: 99%

Haloperidol affects bones while clozapine alters metabolic parameters - sex specific effects in rats perinatally treated with phencyclidine

Nikolić

Petronijević

Sopta

et al. 2017

BMC Pharmacol Toxicol

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BackgroundThe presentation of schizophrenia (SCH) symptoms differs between the sexes. Long-term treatment with antipsychotics is frequently associated with decreased bone mineral density, increased fracture risk and metabolic side effects. Perinatal phencyclidine (PCP) administration to rodents represents an animal model of SCH. The aim of this study was to assess the effects of chronic haloperidol and clozapine treatment on bone mass, body composition, corticosterone, IL-6 and TNF-α concentrations and metabolic parameters in male and female rats perinatally treated with PCP.MethodsSix groups of male and six groups of female rats (n = 6-12 per group) were subcutaneously treated on 2nd, 6th, 9th and 12th postnatal day (PN), with either PCP (10 mg/kg) or saline. At PN35, one NaCl and PCP group (NaCl-H and PCP-H) started receiving haloperidol (1 mg/kg/day) and one NaCl and PCP group (NaCl-C and PCP-C) started receiving clozapine (20 mg/kg/day) dissolved in drinking water. The remaining NaCl and PCP groups received water. Dual X-ray absorptiometry measurements were performed on PN60 and PN98. Animals were sacrificed on PN100. Femur was analysed by light microscopy. Concentrations of corticosterone, TNF-α and IL-6 were measured in serum samples using enzyme-linked immunosorbent assay (ELISA) commercially available kits. Glucose, cholesterol and triacylglycerol concentrations were measured in serum spectrophotometrically.ResultsOur results showed that perinatal PCP administration causes a significant decrease in bone mass and deterioration in bone quality in male and female rats. Haloperidol had deleterious, while clozapine had protective effect on bones. The effects of haloperidol on bones were more pronounced in male rats. It seems that the observed changes are not the consequence of the alterations of corticosterone, IL-6 and TNF-α concentration since no change of these factors was observed. Clozapine induced increase of body weight and retroperitoneal fat in male rats regardless of perinatal treatment. Furthermore, clozapine treatment caused sex specific increase in pro-inflammatory cytokines.ConclusionTaken together our findings confirm that antipsychotics have complex influence on bone and metabolism. Evaluation of potential markers for individual risk of antipsychotics induced adverse effects could be valuable for improvement of therapy of this life-long lasting disease.Electronic supplementary materialThe online version of this article (10.1186/s40360-017-0171-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Haloperidol affects bones while clozapine alters metabolic parameters - sex specific effects in rats perinatally treated with phencyclidine

Nikolić

Petronijević

Sopta

et al. 2017

BMC Pharmacol Toxicol

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“…32,34 Olanzapine is known clinically to have sedative and anxiolytic effects, in addition to AP and mood-stabilizing effects, possibly linked to a Bnormalization[ of the proposed hypothalamic-pituitary-adrenal axis (HPA) hyperactivity in severe mental illness, 19 with a lowering of corticotropin and cortisol. 33,34 Because high HPA activity is one factor believed to increase the disposition of psychiatric patients for insulin resistance, low cortisol levels would be expected to protect against such a development. The present findings indicate that OLZ treatment may contribute to insulin resistance in subjects with psychiatric illness, despite a down-regulation of HPA axis activity.…”

Section: Discussionmentioning

confidence: 99%

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

Birkenaes

Birkeland²,

Friis³

et al. 2009

Journal of Clinical Psychopharmacology

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“…The prevalence of hyperprolactinaemia is higher in people receiving antipsychotics than virtually any other patient or population group. Approximately half of those receiving antipsychotics develop hyperprolactinaemia compared with around 0·4% of the general population 3–6 . A review of 14 cross‐sectional studies including 2235 people receiving antipsychotics found the prevalence of hyperprolactinaemia ranged from 42% to 93% in women and 18% to 72% in men 3 .…”

Section: Prevalence Of Hyperprolactinaemia In People Receiving Antipsmentioning

confidence: 99%

“…Approximately half of those receiving antipsychotics develop hyperprolactinaemia compared with around 0AE4% of the general population. [3][4][5][6] A review of 14 cross-sectional studies including 2235 people receiving antipsychotics found the prevalence of hyperprolactinaemia ranged from 42% to 93% in women and 18% to 72% in men. 3 Women of reproductive age, particularly parous women, appear to be at higher risk of hyperprolactinaemia than post-menopausal women 7 and, although there are only limited data, adolescents are also vulnerable to developing hyperprolactinaemia.…”

Section: Prevalence Of Hyperprolactinaemia In People Receiving Antipsmentioning

confidence: 99%

Antipsychotics and hyperprolactinaemia: mechanisms, consequences and management

Holt¹,

Peveler

2010

Clinical Endocrinology

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Hyperprolactinaemia is a common side effect in people receiving antipsychotics. The propensity to cause hyperprolactinaemia differs markedly between antipsychotics as a result of differential dopamine D(2) receptor-binding affinity and ability to cross the blood-brain barrier. Sexual dysfunction is common and under-recognized in people with severe mental illness and is in part caused by hyperprolactinaemia. There are a number of long-term consequences of hyperprolactinaemia, including osteoporosis. Regular monitoring before and during treatment will help identify those developing antipsychotic-induced hyperprolactinaemia. The treatment includes dose reduction and change in antipsychotic. Where this is not possible because of the risk of relapse of the mental illness, sex steroid replacement may be helpful in improving symptoms secondary to hypogonadism and reducing the risk of osteoporosis. Tertiary prevention of complications should also be considered.

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The effects of olanzapine and fluphenazine on plasma cortisol, prolactin and muscle rigidity in schizophrenic patients: A double blind study

Cited by 22 publications

References 24 publications

Haloperidol affects bones while clozapine alters metabolic parameters - sex specific effects in rats perinatally treated with phencyclidine

Haloperidol affects bones while clozapine alters metabolic parameters - sex specific effects in rats perinatally treated with phencyclidine

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

Antipsychotics and hyperprolactinaemia: mechanisms, consequences and management

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