Ziprasidone decreases cortisol excretion in healthy subjects

Meier, Andreas; Neumann, Anna-Catharina; Jordan, Wolfgang; Huether, Gerald; Rodenbeck, Andrea; Rüther, Eckart; Cohrs, Stefan

doi:10.1111/j.1365-2125.2005.02431.x

Cited by 19 publications

(9 citation statements)

References 39 publications

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“…Regarding these data, one may conclude that antagonism of central 5‐HT 2A/C and/or histamine H 1 receptors is responsible for the acute inhibitory effects of mirtazapine on cortisol and ACTH secretion in healthy volunteers. This assumption is further corroborated by the finding that atypical antipsychotics with 5‐HT 2 ‐ and H 1 ‐blocking properties, such as quetiapine (135–137), olanzapine (136) or ziprasidone (138), but not the classical dopamine D 2 ‐antagonist haloperidol (70, 136) have also been demonstrated to acutely inhibit cortisol secretion in healthy subjects.…”

Section: Mirtazapine Challenge and Hpa Axis Activity In Healthy Subjectsmentioning

confidence: 73%

Neuroendocrinological Mechanisms of Actions of Antidepressant Drugs

Schüle

2006

J Neuroendocrinology

149

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Noradrenaline or serotonin (5-HT) reuptake-inhibiting antidepressants such as reboxetine or citalopram acutely stimulate cortisol and adrenocorticotrophic hormone (ACTH) secretion in healthy volunteers, whereas mirtazapine acutely inhibits the ACTH and cortisol release, probably due to its antagonism at central 5-HT(2) and/or H(1) receptors. These differential effects of antidepressants on cortisol and ACTH secretion in healthy subjects after single administration are also reflected by their different time course in the down-regulation of hypothalamic-pituitary-adrenocortical (HPA) axis hyperactivity in depressed patients as assessed by serial dexamethasone (DEX)/corticotrophin-releasing hormone (CRH) tests: Reuptake-inhibiting antidepressants such as reboxetine gradually normalise HPA axis hyperactivity in depressed patients during several weeks of treatment via up-regulation of mineralocorticoid and glucocorticoid receptor function and by step-by-step restoration of the disturbed feedback control. By contrast, mirtazapine markedly reduces HPA axis activity in depressed patients within 1 week, but there is a partial re-enhancement of HPA hormone secretion after several weeks of therapy. In all studies performed to date, the short-term effects of daily treatment with antidepressants on the DEX/CRH test results are comparable in responders and nonresponders. Moreover, a reduction in HPA axis activity is not necessarily followed by a favourable clinical response and some depressed patients keep on showing nonsuppression in the DEX/CRH test despite clinical improvement. Therefore, the importance of HPA axis dysregulation for the short-term efficacy of antidepressants continues to be a matter of debate. However, there are convincing data suggesting that persisting nonsuppression in the DEX/CRH test despite clinical remission predicts an enhanced risk for relapse of depressive symptomatology with respect to the medium- and long-term outcome.

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Section: Mirtazapine Challenge and Hpa Axis Activity In Healthy Subjectsmentioning

confidence: 73%

Neuroendocrinological Mechanisms of Actions of Antidepressant Drugs

Schüle

2006

J Neuroendocrinology

149

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“…There is a case study that reported elevated PRL levels after 9 days of ziprasidone administration (80 mg/day) (257,258). Moreover, other studies have shown that ziprasidone suppresses the activity of the HPA-axis (n = 11, healthy volunteers; 40 mg/day), reducing the levels of nocturnal cortisol excretion, likely due to its antagonism toward H1 and α1 adrenergic receptors (259). Studies on the adverse effects produced by ziprasidone are scarce and more research is needed.…”

Section: Ziprasidonementioning

confidence: 99%

Immunoendocrine Peripheral Effects Induced by Atypical Antipsychotics

et al. 2020

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Atypical antipsychotics (AAP) or second-generation antipsychotics are the clinical option for schizophrenia treatment during acute psychoses, but they are also indicated for maintenance during lifetime, even though they are being used for other psychiatric conditions in clinical practice such as affective disorders and autism spectrum disorder, among others. These drugs are differentiated from typical antipsychotics based on their clinical profile and are a better choice because they cause fewer side effects regarding extrapyramidal symptoms (EPS). Even though they provide clear therapeutic benefits, AAP induce peripheral effects that trigger phenotypic, functional, and systemic changes outside the Central Nervous System (CNS). Metabolic disease is frequently associated with AAP and significantly impacts the patient's quality of life. However, other peripheral changes of clinical relevance are present during AAP treatment, such as alterations in the immune and endocrine systems as well as the intestinal microbiome. These less studied alterations also have a significant impact in the patient's health status. This manuscript aims to revise the peripheral immunological, endocrine, and intestinal microbiome changes induced by AAP consumption recommended in the clinical guidelines for schizophrenia and other psychiatric disorders.

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“…The administration of ziprasidone and quetia- pine decreases the urinary cortisol excretion in healthy subjects [22,46] . Olanzapine also reduces the ACTH and cortisol secretion in healthy subjects, whereas haloperidol has no such affect.…”

Section: Discussionmentioning

confidence: 99%

“…As mentioned earlier, CRF is a regulatory factor in HPA axis activity and in the pathophysiology of depression and anxiety. In healthy subjects, ziprasidone decreased cortisol excretion [22] . However, no study has examined the effects of ziprasidone on stress-induced CRF.…”

Section: Introductionmentioning

confidence: 99%

Differential Effects of Ziprasidone and Haloperidol on Immobilization-Stress-Induced CRF mRNA Expression in the Hypothalamic Paraventricular Nucleus of Rats

Park

Choi²,

Lee³

et al. 2010

Neuropsychobiology

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Objectives: Corticotropin-releasing factor (CRF) plays a prominent role in mediating the effect of stressors on the hypothalamic-pituitary-adrenal axis. In this study, we examined the effects of chronic administration of second-generation antipsychotic drug ziprasidone on CRF mRNA expression in the hypothalamic paraventricular nucleus (PVN) of rats with or without immobilization stress. Methods: The rats were subjected to immobilization stress 2 h/day for 3 weeks. The effect of ziprasidone (2.5 mg/kg, 21 days) on CRF mRNA expression was determined using in situ hybridization of tissue sections from the rat hypothalamic PVN. Haloperidol (1.0 mg/kg, 21 days) was used for comparison. Results: Haloperidol increased the expression of CRF mRNA in the PVN under basal conditions, whereas ziprasidone had no effect. Chronic immobilization stress increased CRF expression. The chronic administration of ziprasidone prevented the increase in CRF mRNA expression caused by immobilization stress. Conclusions: These results suggest that ziprasidone may have a regulatory effect on the stress-induced CRF mRNA expression and a role in the treatment of depressive mood symptom.

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Ziprasidone decreases cortisol excretion in healthy subjects

Cited by 19 publications

References 39 publications

Neuroendocrinological Mechanisms of Actions of Antidepressant Drugs

Neuroendocrinological Mechanisms of Actions of Antidepressant Drugs

Immunoendocrine Peripheral Effects Induced by Atypical Antipsychotics

Differential Effects of Ziprasidone and Haloperidol on Immobilization-Stress-Induced CRF mRNA Expression in the Hypothalamic Paraventricular Nucleus of Rats

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