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Simon MS, Barton BB, Glocker C, Musil R. A comprehensive approach to predicting weight gain and therapy response in psychopharmacologically treated major depressed patients: A cohort study protocol. PLoS One 2022; 17:e0271793. [PMID: 35862413 PMCID: PMC9302848 DOI: 10.1371/journal.pone.0271793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 07/07/2022] [Indexed: 11/22/2022] Open
Abstract
Background A subgroup of patients with Major Depressive Disorder shows signs of low-grade inflammation and metabolic abberances, while antidepressants can induce weight gain and subsequent metabolic disorders, and lacking antidepressant response is associated with inflammation. Objectives A comprehensive investigation of patient phenotypes and their predictive capability for weight gain and treatment response after psychotropic treatment will be performed. The following factors will be analyzed: inflammatory and metabolic markers, gut microbiome composition, lifestyle indicators (eating behavior, physical activity, chronotype, patient characteristics (childhood adversity among others), and polygenic risk scores. Methods Psychiatric inpatients with at least moderate Major Depressive Disorder will be enrolled in a prospective, observational, naturalistic, monocentric study using stratified sampling. Ethical approval was obtained. Primary outcomes at 4 weeks will be percent weight change and symptom score change on the Montgomery Asberg Depression Rating Scale. Both outcomes will also be binarized into clinically relevant outcomes at 5% weight gain and 50% symptom score reduction. Predictors for weight gain and treatment response will be tested using multiple hierachical regression for continuous outcomes, and multiple binary logistic regression for binarized outcomes. Psychotropic premedication, current medication, eating behavior, baseline BMI, age, and sex will be included as covariates. Further, a comprehensive analysis will be carried out using machine learning. Polygenic risk scores will be added in a second step to estimate the additional variance explained by genetic markers. Sample size calculation yielded a total amount of N = 171 subjects. Discussion Patient and physician expectancies regarding the primary outcomes and non-random sampling may affect internal validity and external validity, respectively. Through the prospective and naturalistic design, results will gain relevance to clinical practice. Examining the predictive value of patient profiles for weight gain and treatment response during pharmacotherapy will allow for targeted adjustments before and concomitantly to the start of treatment.
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Affiliation(s)
- Maria S. Simon
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
- * E-mail:
| | - Barbara B. Barton
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Catherine Glocker
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
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Emmanoella Sebulsqui Saraiva T, Rodrigues GZP, Kayser JM, Dallegrave E, Pulz Maus N, Veiverberg A, da Costa Berna G, Schuster AC, Gabriela de Freitas M, Galdino da Rocha Pitta M, da Rocha Pitta I, Gehlen G, Betti AH. Study of the acute and repeated dose 28-day oral toxicity in mice treated with PT-31, a molecule with potential antipsychotic profile. Toxicol Mech Methods 2022; 32:705-715. [PMID: 35410575 DOI: 10.1080/15376516.2022.2065226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Schizophrenia is a psychiatric disorder that affects 1% of the world population and is treated with antipsychotics, which may induce important biochemical and hematological alterations. Since it is necessary to verify the safety of new molecules with antipsychotic potential, the present study aimed to evaluate the oral toxicity of PT-31, a putative α2-adrenoreceptor agonist, after acute (2000 mg/kg) and repeated doses (28 days) gavage treatment, in three different doses: minimum effective dose in animal models (10 mg/kg), twice the dose (20 mg/kg), and four times the dose (40 mg/kg), as recommended by the OECD guidelines. Balb/C female adult mice were used, and biochemical, hematological, and histopathological analyses were performed. PT-31 10 and 20 mg/kg did not cause biochemical alterations related to hepatic and renal toxicity, and neither altered glycemic and lipid profiles. The preclinical dose of PT-31 also did not promote mice histopathological changes in the liver, kidney, and brain. In the hematimetric parameters, PT-31 only increased HGB at 20 mg/kg, and MCH and MCHC at 40 mg/kg. However, all the tested doses of PT-31 showed platelet increase, which must be better investigated. Therefore, further studies are needed to investigate the safety of PT-31 as a potential antipsychotic drug.
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Affiliation(s)
| | | | - Juliana Machado Kayser
- Institute of Health Sciences, Feevale University, Novo Hamburgo, Rio Grande do Sul, Brazil
| | - Eliane Dallegrave
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Nathália Pulz Maus
- Institute of Health Sciences, Feevale University, Novo Hamburgo, Rio Grande do Sul, Brazil
| | - Andriele Veiverberg
- Institute of Health Sciences, Feevale University, Novo Hamburgo, Rio Grande do Sul, Brazil
| | - Gabriel da Costa Berna
- Institute of Health Sciences, Feevale University, Novo Hamburgo, Rio Grande do Sul, Brazil
| | | | | | | | - Ivan da Rocha Pitta
- Research Centre for Therapeutic Innovation. Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Günther Gehlen
- Institute of Health Sciences, Feevale University, Novo Hamburgo, Rio Grande do Sul, Brazil
| | - Andresa Heemann Betti
- Institute of Health Sciences, Feevale University, Novo Hamburgo, Rio Grande do Sul, Brazil
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Chung J, Miller BJ. Meta-analysis of comorbid diabetes and family history of diabetes in non-affective psychosis. Schizophr Res 2020; 216:41-47. [PMID: 31806529 DOI: 10.1016/j.schres.2019.10.062] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Schizophrenia and other non-affective psychoses (NAP) are associated with an increased prevalence of both type 2 diabetes (DM2) as well as a family history of DM2. We performed a systematic review and meta-analysis of the association between comorbid DM2 and a family history of DM2 in patients with NAP. METHOD We searched major electronic databases from inception until August 2018 for studies of comorbid DM2 in patients with non-affective psychosis and family history of DM2 status. Random effects meta-analysis calculating odds ratios (ORs) and 95% confidence intervals (CI) and meta-regression analyses were performed. RESULTS Ten studies met the inclusion criteria. Across these studies, there were 804 patients with non-affective psychosis and comorbid DM2, and 2976 patients with non-affective psychosis without this comorbidity. A family history of DM2 was associated with an over four-fold increased odds of comorbid DM2 in patients with NAP (OR = 4.3, 95% CI 2.9-6.4, p<0.001). In; meta-regression analyses older age, but not sex, BMI, geographic region, study quality, or year; of publication moderated the association between comorbid DM2 and family history of DM2. CONCLUSION We found that a family history of DM2 was associated with an over four-fold increased odds of comorbid DM2 in patients with NAP. This association may be due to shared environmental or genetic risk factors, or gene-environment interactions. Given the increased risk of incident diabetes with antipsychotic treatment, screening for a family history of DM2 is germane to the clinical care of patients with NAP.
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Affiliation(s)
- Jim Chung
- Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States
| | - Brian J Miller
- Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States.
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Li R, Ou J, Li L, Yang Y, Zhao J, Wu R. The Wnt Signaling Pathway Effector TCF7L2 Mediates Olanzapine-Induced Weight Gain and Insulin Resistance. Front Pharmacol 2018; 9:379. [PMID: 29713286 PMCID: PMC5911481 DOI: 10.3389/fphar.2018.00379] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 04/03/2018] [Indexed: 12/30/2022] Open
Abstract
Olanzapine is a widely used atypical antipsychotic medication for treatment of schizophrenia and is often associated with serious metabolic abnormalities including weight gain and impaired glucose tolerance. These metabolic side effects are severe clinical problems but the underpinning mechanism remains poorly understood. Recently, growing evidence suggests that Wnt signaling pathway has a critical role in the pathogenesis of schizophrenia and molecular cascades of antipsychotics action, of which Wnt signaling pathway key effector TCF7L2 is strongly associated with glucose homeostasis. In this study, we aim to explore the characteristics of metabolic disturbance induced by olanzapine and to elucidate the role of TCF7L2 in this process. C57BL/6 mice were subject to olanzapine (4 mg/kg/day), or olanzapine plus metformin (150 mg/kg/day), or saline, respectively, for 8 weeks. Metabolic indices and TCF7L2 expression levels in liver, skeletal muscle, adipose, and pancreatic tissues were closely monitored. Olanzapine challenge induced remarkably increased body weight, fasting insulin, homeostasis model assessment-insulin resistance index, and TCF7L2 protein expression in liver, skeletal muscle, and adipose tissues. Notably, these effects could be effectively ameliorated by metformin. In addition, we found that olanzapine-induced body weight gain and insulin resistance actively influence the expression of TCF7L2 in liver and skeletal muscle, and elevated level of insulin determines the increased expression of TCF7L2 in adipose tissue. Our results demonstrate that TCF7L2 participates in olanzapine-induced metabolic disturbance, which presents a novel mechanism for olanzapine-induced metabolic disturbance and a potential therapeutic target to prevent the associated metabolic side effects.
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Affiliation(s)
- Ranran Li
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jianjun Ou
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Li Li
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ye Yang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Renrong Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Shanghai Institute for Biological Science, Chinese Academy of Sciences, Shanghai, China
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Evers SS, Boersma GJ, Tamashiro KL, Scheurink AJ, van Dijk G. Roman high and low avoidance rats differ in their response to chronic olanzapine treatment at the level of body weight regulation, glucose homeostasis, and cortico-mesolimbic gene expression. J Psychopharmacol 2017; 31:1437-1452. [PMID: 28892416 DOI: 10.1177/0269881117724749] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Olanzapine, an antipsychotic agent mainly used for treating schizophrenia, is frequently associated with body weight gain and diabetes mellitus. Nonetheless, studies have shown that not every individual is equally susceptible to olanzapine's weight-gaining effect. Therefore, Roman high and low avoidance rat strains were examined on their responsiveness to olanzapine treatment. The Roman high avoidance rat shares many behavioral and physiological characteristics with human schizophrenia, such as increased central dopaminergic sensitivity, whereas the Roman low avoidance rat has been shown to be prone to diet-induced obesity and insulin resistance. The data revealed that only the Roman high avoidance rats are susceptible to olanzapine-induced weight gain and attenuated glucose tolerance. Here it is suggested that the specific olanzapine-induced weight gain in Roman high avoidance rats could be related to augmented dopaminergic sensitivity at baseline through increased expression of prefrontal cortex dopamine receptor D1 mRNA and nucleus accumbens dopamine receptor D2 mRNA expression. Regression analyses revealed that olanzapine-induced weight gain in the Roman high avoidance rat is above all related to increased prolactin levels, whereas changes in glucose homeostasis is best explained by differences in central dopaminergic receptor expressions between strains and treatment. Our data indicates that individual differences in dopaminergic receptor expression in the cortico-mesolimbic system are related to susceptibility to olanzapine-induced weight gain.
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Affiliation(s)
- Simon S Evers
- 1 Department of Behavioral Neurosciences, University of Groningen, Nijenborgh, the Netherlands.,2 Department of Surgery, University of Michigan, Michigan, USA
| | - Gretha J Boersma
- 3 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, USA.,4 Department of Medical Sciences, Clinical Diabetology and Metabolism, University of Uppsala, Uppsala, Sweden
| | - Kellie Lk Tamashiro
- 3 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, USA
| | - Anton Jw Scheurink
- 1 Department of Behavioral Neurosciences, University of Groningen, Nijenborgh, the Netherlands
| | - Gertjan van Dijk
- 1 Department of Behavioral Neurosciences, University of Groningen, Nijenborgh, the Netherlands
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Stefanidis A, Watt MJ, Cowley MA, Oldfield BJ. Prevention of the adverse effects of olanzapine on lipid metabolism with the antiepileptic zonisamide. Neuropharmacology 2017; 123:55-66. [PMID: 28400260 DOI: 10.1016/j.neuropharm.2017.04.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 04/05/2017] [Accepted: 04/07/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Atypical antipsychotic drugs, particularly olanzapine, represent a mainstay in the treatment of psychoses; however, their use is commonly associated with weight gain and diabetes. The aim of this study was to determine whether combined administration of olanzapine and zonisamide can be used to prevent olanzapine-induced metabolic disturbances. METHODS AND RESULTS These experiments involved female Sprague Dawley rats (n = 6-8/group) that were administered olanzapine, either acutely (6 mg/kg, s. c) or via continuous osmotic minipump infusion (6 mg/kg/day for 6 or 14 days), in combination with zonisamide (26 mg/kg/day,i.p.). Continuous infusion of olanzapine induced accumulation of adipose tissue and an associated reduction in stimulated lipolysis and reduced protein expression of CGI-58, a critical co-activator of ATGL. Olanzapine treatment caused a preferential shift toward carbohydrate oxidation (or reduced fat oxidation), elevated blood triglycerides and a reduction in locomotor activity. Olanzapine had a direct effect on glucose regulation, causing rapid hyperglycemia, and a reduction in glucose tolerance and insulin sensitivity. Continuous administration of olanzapine caused significant hyperinsulinemia and a significant reduction in insulin sensitivity. Zonisamide did not affect the impact of olanzapine on glucose homeostasis. On the other hand, co-administration of olanzapine with zonisamide completely ameliorated olanzapine-mediated shifts in lipid metabolism resulting in a normalization of olanzapine-induced weight gain. CONCLUSION These data collectively show an impact of olanzapine on body weight and lipid metabolism, which is ameliorated by co-administration with zonisamide. These findings suggest that a combined olanzapine and zonisamide approach might reduce weight gain, but will not provide protection against olanzapine-induced glucose intolerance.
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Affiliation(s)
- Aneta Stefanidis
- Department of Physiology, Monash University, Clayton, Victoria, Australia, Metabolic Disease and Obesity Program, Biomedicine Discovery Institute, Monash University.
| | - Matthew J Watt
- Department of Physiology, Monash University, Clayton, Victoria, Australia, Metabolic Disease and Obesity Program, Biomedicine Discovery Institute, Monash University
| | - Michael A Cowley
- Department of Physiology, Monash University, Clayton, Victoria, Australia, Metabolic Disease and Obesity Program, Biomedicine Discovery Institute, Monash University
| | - Brian J Oldfield
- Department of Physiology, Monash University, Clayton, Victoria, Australia, Metabolic Disease and Obesity Program, Biomedicine Discovery Institute, Monash University
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Horska K, Ruda-Kucerova J, Babinska Z, Karpisek M, Demlova R, Opatrilova R, Suchy P, Kotolova H. Olanzapine-depot administration induces time-dependent changes in adipose tissue endocrine function in rats. Psychoneuroendocrinology 2016; 73:177-185. [PMID: 27504985 DOI: 10.1016/j.psyneuen.2016.07.218] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 06/23/2016] [Accepted: 07/26/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Metabolic adverse effects of atypical antipsychotics (AAP) contribute significantly to increased risk of cardiovascular morbidity and mortality in patients suffering from schizophrenia. Extensive preclinical research has addressed this issue over the past years, though mechanisms underlying these adverse effects of AAP are still not understood completely. Recently, attention is drawn towards the role of adipose tissue metabolism and neurohormonal regulations. METHODS The aim of this study was to evaluate the time-dependent effects of olanzapine depot administration at clinically relevant dosing on the regulation of energy homeostasis, glucose and lipid metabolism, gastrointestinal and adipose tissue-derived hormones involved in energy balance regulations in female Sprague-Dawley rats. The study lasted 8 weeks and the markers were assayed at day 8, 15, 29, 43 and 57. RESULTS The results indicate that in the absence of hyperphagia, olanzapine chronic exposure induced weight gain from the beginning of the study. In the later time-point, increased adiposity was also observed. In the initial phase of the study, lipid profile was altered by an early increase in triglyceride level and highly elevated leptin level was observed. Clear bi-phasic time-dependent effect of olanzapine on leptin serum concentration was demonstrated. Olanzapine treatment did not lead to changes in serum levels of ghrelin, FGF-21 and pro-inflammatory markers IL-1a, IL-6 and TNF-α at any time-point of the study. CONCLUSION This study provides data suggesting early alteration in adipose tissue endocrine function as a factor involved in mechanisms underlying metabolic adverse effects of antipsychotics.
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Affiliation(s)
- Katerina Horska
- Department of Pharmacology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Jana Ruda-Kucerova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Zuzana Babinska
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Michal Karpisek
- R&D Department, Biovendor - Laboratorni Medicina, Brno, Czech Republic; Department of Pharmacology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Regina Demlova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Radka Opatrilova
- Department of Chemical Drugs, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Pavel Suchy
- Department of Pharmacology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Hana Kotolova
- Department of Pharmacology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
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Hegedűs C, Kovács D, Kiss R, Sári R, Németh J, Szilvássy Z, Peitl B. Effect of long-term olanzapine treatment on meal-induced insulin sensitization and on gastrointestinal peptides in female Sprague-Dawley rats. J Psychopharmacol 2015; 29:1271-9. [PMID: 26349558 DOI: 10.1177/0269881115602952] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Meal-induced insulin sensitization (MIS), an endogenous adaptive mechanism is activated post-prandially. Reduced MIS leads to diabetes, but its activation improves insulin sensitivity. MIS is preserved to single olanzapine administration, therefore we aimed to investigate the chronic effect of olanzapine on fasted-state insulin sensitivity and on MIS in female Sprague-Dawley rats. Daily food and water intake, stool and urine production and body weight were determined. The MIS was characterized by a rapid insulin sensitivity test. Fasting hepatic and peripheral insulin sensitivity were determined by a hyperinsulinaemic euglycaemic glucose clamping supplemented with radiotracer technique. Fasted and post-prandial blood samples were obtained for plasma insulin, leptin, ghrelin, amylin, GLP-1, GIP, PYY and PP determination. Adiposity was characterized by weighing intra-abdominal and inguinal fat pads. Olanzapine caused hepatic insulin resistance and a reduced metabolic clearance rate of insulin, but the MIS retained its function. Body weight and adiposity were enhanced, but olanzapine failed to increase food intake. Fasting insulin and leptin were elevated and the post-prandial reduction in ghrelin level was inhibited by olanzapine.The MIS remained functionally intact after long-term olanzapine treatment. Altered insulin, leptin and ghrelin levels indicate olanzapine-induced metabolic derangements. Pharmacological activation of MIS could potentially be exploited to treat or prevent olanzapine-induced insulin resistance.
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Affiliation(s)
| | - Diána Kovács
- Department of Pharmacology and Pharmacotherapy, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Rita Kiss
- Department of Pharmacology and Pharmacotherapy, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Réka Sári
- Department of Pharmacology and Pharmacotherapy, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - József Németh
- Department of Pharmacology and Pharmacotherapy, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Zoltán Szilvássy
- Department of Pharmacology and Pharmacotherapy, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Barna Peitl
- Department of Pharmacology and Pharmacotherapy, University of Debrecen Faculty of Medicine, Debrecen, Hungary
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Fernø J, Ersland KM, Duus IH, González-García I, Fossan KO, Berge RK, Steen VM, Skrede S. Olanzapine depot exposure in male rats: Dose-dependent lipogenic effects without concomitant weight gain. Eur Neuropsychopharmacol 2015; 25:923-32. [PMID: 25823694 DOI: 10.1016/j.euroneuro.2015.03.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 01/29/2015] [Accepted: 03/09/2015] [Indexed: 11/28/2022]
Abstract
Treatment with second-generation antipsychotic agents such as olanzapine frequently results in metabolic adverse effects, e.g. hyperphagia, weight gain and dyslipidaemia in patients of both genders. The molecular mechanisms underlying metabolic adverse effects are still largely unknown, and studies in rodents represent an important approach in their exploration. However, the validity of the rodent model is hampered by the fact that antipsychotics induce weight gain in female, but not male, rats. When administered orally, the short half-life of olanzapine in rats prevents stable plasma concentrations of the drug. We recently showed that a single intramuscular injection of long-acting olanzapine formulation yields clinically relevant plasma concentrations accompanied by several dysmetabolic features in the female rat. In the current study, we show that depot injections of 100-250 mg/kg olanzapine yielded clinically relevant plasma olanzapine concentrations also in male rats. In spite of transient hyperphagia, however, olanzapine resulted in weight loss rather than weight gain. The resultant negative feed efficiency was accompanied by a slight elevation of thermogenesis markers in brown adipose tissue for the highest olanzapine dose, but the olanzapine-related reduction in weight gain remains to be explained. In spite of the absence of weight gain, an olanzapine dose of 200mg/kg or above induced significantly elevated plasma cholesterol levels and pronounced activation of lipogenic gene expression in the liver. These results confirm that olanzapine stimulates lipogenic effects, independent of weight gain, and raise the possibility that endocrine factors may influence gender specificity of metabolic effects of antipsychotics in the rat.
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Affiliation(s)
- J Fernø
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, N-5021 Bergen, Norway; The Norwegian Centre for Mental Disorders Research (NORMENT) and the K.G. Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Norway.
| | - K M Ersland
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, N-5021 Bergen, Norway; The Norwegian Centre for Mental Disorders Research (NORMENT) and the K.G. Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Norway
| | - I H Duus
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, N-5021 Bergen, Norway; The Norwegian Centre for Mental Disorders Research (NORMENT) and the K.G. Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Norway
| | - I González-García
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, N-5021 Bergen, Norway; The Norwegian Centre for Mental Disorders Research (NORMENT) and the K.G. Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Norway
| | - K O Fossan
- Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - R K Berge
- The Lipid Research Group, Section for Medical Biochemistry, Department of Clinical Science, University of Bergen, 5021 Norway; Department of Heart Disease, University of Bergen, 5021 Norway
| | - V M Steen
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, N-5021 Bergen, Norway; The Norwegian Centre for Mental Disorders Research (NORMENT) and the K.G. Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Norway
| | - S Skrede
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, N-5021 Bergen, Norway; The Norwegian Centre for Mental Disorders Research (NORMENT) and the K.G. Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Norway
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Henderson DC, Vincenzi B, Andrea NV, Ulloa M, Copeland PM. Pathophysiological mechanisms of increased cardiometabolic risk in people with schizophrenia and other severe mental illnesses. Lancet Psychiatry 2015; 2:452-464. [PMID: 26360288 DOI: 10.1016/s2215-0366(15)00115-7] [Citation(s) in RCA: 184] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 03/12/2015] [Accepted: 03/13/2015] [Indexed: 12/14/2022]
Abstract
Patients with schizophrenia have increased mortality and morbidity compared with the general population. These patients have a 20-year shorter lifespan than peers without schizophrenia, mainly due to premature cardiovascular disease, suicide, and cancer. Patients with severe mental illness are at increased risk for cardiovascular disease related to increased incidence of diabetes, hypertension, smoking, poor diet, obesity, dyslipidaemia, metabolic syndrome, low physical activity, and side-effects of antipsychotic drugs. Some second-generation antipsychotics (eg, clozapine, olanzapine, quetiapine, and risperidone) are associated with an increased risk of weight gain and obesity, impaired glucose tolerance and new-onset diabetes, hyperlipidaemia, and cardiovascular disease. The mechanisms by which schizophrenia and patients with severe mental illness are susceptible to cardiometabolic disorders are complex and include lifestyle risks and direct and indirect effects of antipsychotic drugs. An understanding of these risks might lead to effective interventions for prevention and treatment of cardiometabolic disorders in schizophrenia and severe mental illness.
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Affiliation(s)
- David C Henderson
- Schizophrenia Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry and Epidemiology, Harvard Medical School, Harvard School of Public Health, Boston, MA, USA; Department of Medicine, Harvard Medical School, Harvard School of Public Health, Boston, MA, USA.
| | - Brenda Vincenzi
- Schizophrenia Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Nicolas V Andrea
- Schizophrenia Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Melissa Ulloa
- Schizophrenia Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Paul M Copeland
- Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA
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