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Zhang C, Zheng D, Feng W, Zhang H, Han F, He W, Liu A, Huang H, Chen J. Olanzapine: Association Between a Typical Antipsychotic Drug and Aortic Calcification. Front Cardiovasc Med 2021; 8:710090. [PMID: 34568454 PMCID: PMC8460775 DOI: 10.3389/fcvm.2021.710090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: This study concentrates on the relationship between antipsychotic drugs (APDs) and aortic calcification. Methods: All 56 patients with schizophrenia were divided into two groups according to aortic calcification index. APD equivalent dose was calculated via defined daily doses method. Results: In schizophrenia patients with higher aortic calcification index scores, APD equivalent doses were lower. APD equivalent dose was negatively related to aortic calcification index. Although equivalent APD dose in patients without olanzapine treatment was negatively related to aortic calcification index, it seems that equivalent APD dose did not associate with aortic calcification. Conclusion: Aortic calcification is negatively associated with APD dose in schizophrenia patients. Olanzapine seems to be vital to the relationship between aortic calcification and APD treatment.
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Affiliation(s)
- Chao Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dongdong Zheng
- Department of Psychiatry, Psychiatric Hospital of Guangzhou Civil Affairs Bureau, Guangzhou, China
| | - Weijing Feng
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huanji Zhang
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Feng Han
- Department of Ultrasound, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Wanbing He
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Aiting Liu
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Hui Huang
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Jie Chen
- Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Romo-Nava F, Buijs RM, McElroy SL. The use of melatonin to mitigate the adverse metabolic side effects of antipsychotics. HANDBOOK OF CLINICAL NEUROLOGY 2021; 179:371-382. [PMID: 34225976 DOI: 10.1016/b978-0-12-819975-6.00024-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Antipsychotic drugs are efficacious first-line treatments for many individuals diagnosed with a psychiatric illness. However, their adverse metabolic side-effect profile, which resembles the metabolic syndrome, represents a significant clinical problem that increases morbidity and limits treatment adherence. Moreover, the mechanisms involved in antipsychotic-induced adverse metabolic effects (AMEs) are unknown and mitigating strategies and interventions are limited. However, recent clinical trials show that nightly administration of exogenous melatonin may mitigate or even prevent antipsychotic-induced AMEs. This clinical evidence in combination with recent preclinical data implicate the circadian system in antipsychotic-induced AMEs and their mitigation. In this chapter, we provide an overview on the circadian system and its involvement in antipsychotic-induced AMEs, as well as the potential beneficial effect of nightly melatonin administration to mitigate them.
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Affiliation(s)
- Francisco Romo-Nava
- Lindner Center of HOPE Research Institute, Lindner Center of HOPE, Mason, OH, United States; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
| | - Ruud M Buijs
- Hypothalamic Integration Mechanisms Laboratory, Department of Cellular Biology and Physiology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, Mexico
| | - Susan L McElroy
- Lindner Center of HOPE Research Institute, Lindner Center of HOPE, Mason, OH, United States; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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A Randomized, 8-Week Study of the Effects of Extended-Release Paliperidone and Olanzapine on Heart Rate Variability in Patients With Schizophrenia. J Clin Psychopharmacol 2019; 39:243-248. [PMID: 30925499 DOI: 10.1097/jcp.0000000000001023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE This study aimed to explore the effect of extended-release paliperidone (paliperidone ER) and olanzapine on heart rate variability (HRV) in patients with schizophrenia. METHODS A total of 106 patients with schizophrenia diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) were randomly divided into the paliperidone ER group or the olanzapine group for an 8-week clinical trial, with 53 patients in each group. The time domain and frequency domain analyses including the SD of all the R-R intervals in 24 hours (SDNN), the SD of the mean value of all the normal R-R intervals in every 5-minute interval within 24 hours (SDANN index), the mean value of the SD of all the normal R-R intervals in every 5-minute interval within 24 hours (SDNN index), the root mean square of successive R-R differences, the percentage of adjacent R-R intervals that differ by more than 50 milliseconds, high-frequency power (HF), low-frequency power (LF), and LF/HF were adopted to assess the HRV of patients at baseline and after treatment for 8 weeks in each group. The Positive and Negative Symptom Scale was used to evaluate the clinical efficacy. The incidence rates of adverse reactions were also calculated. RESULTS In total, 48 patients in the paliperidone ER group and 45 patients in the olanzapine group completed the entire 8-week treatment. The SDNN, SDNN index, and SDANN index in the olanzapine group were significantly lower than those in the paliperidone ER group (P < 0.05) after treatment for 8 weeks, whereas their mean LF level was higher than that in the paliperidone ER group (P < 0.05) after completion of treatment. Patients in the olanzapine group showed a significant decrease in the SDNN, SDANN index, and SDNN index as well as a statistical increase in the LF and LF/HF in comparison with the pretreatment values (P < 0.05), whereas patients in the paliperidone ER group showed a decrease in the SDANN index and a statistical increase in the LF in comparison with the pretreatment values (P < 0.05). CONCLUSION The HRV of patients with schizophrenia changes when they are administered with paliperidone ER or olanzapine, and more attention should be paid to their cardiac autonomic function when using these 2 antipsychotics.
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De R, Mazumder S, Sarkar S, Debsharma S, Siddiqui AA, Saha SJ, Banerjee C, Nag S, Saha D, Bandyopadhyay U. Acute mental stress induces mitochondrial bioenergetic crisis and hyper-fission along with aberrant mitophagy in the gut mucosa in rodent model of stress-related mucosal disease. Free Radic Biol Med 2017; 113:424-438. [PMID: 28993273 DOI: 10.1016/j.freeradbiomed.2017.10.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/06/2017] [Accepted: 10/06/2017] [Indexed: 12/18/2022]
Abstract
Psychological stress, depression and anxiety lead to multiple organ dysfunctions wherein stress-related mucosal disease (SRMD) is common to people experiencing stress and also occur as a side effect in patients admitted to intensive care units; however the underlying molecular aetiology is still obscure. We report that in rat-SRMD model, cold restraint-stress severely damaged gut mitochondrial functions to generate superoxide anion (O2•-), depleted ATP and shifted mitochondrial fission-fusion dynamics towards enhanced fission to induce mucosal injury. Activation of mitophagy to clear damaged and fragmented mitochondria was evident from mitochondrial translocation of Parkin and PINK1 along with enhanced mitochondrial proteome ubiquitination, depletion of mitochondrial DNA copy number and TOM 20. However, excess and sustained accumulation of O2•--generating defective mitochondria overpowered the mitophagic machinery, ultimately triggering Bax-dependent apoptosis and NF-κB-intervened pro-inflammatory mucosal injury. We further observed that stress-induced enhanced serum corticosterone stimulated mitochondrial recruitment of glucocorticoid receptor (GR), which contributed to gut mitochondrial dysfunctions as documented from reduced ETC complex 1 activity, mitochondrial O2•- accumulation, depolarization and hyper-fission. GR-antagonism by RU486 or specific scavenging of mitochondrial O2•- by a mitochondrially targeted antioxidant mitoTEMPO ameliorated stress-induced mucosal damage. Gut mitopathology and mucosal injury were also averted when the perception of mental stress was blocked by pre-treatment with a sedative or antipsychotic. Altogether, we suggest the role of mitochondrial GR-O2•--fission cohort in brain-mitochondria cross-talk during acute mental stress and advocate the utilization of this pathway as a potential target to prevent mitochondrial unrest and gastropathy bypassing central nervous system.
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MESH Headings
- Adenosine Triphosphate/metabolism
- Animals
- Antipsychotic Agents/pharmacology
- Cold Temperature
- Corticosterone/blood
- Electron Transport Complex I/genetics
- Electron Transport Complex I/metabolism
- Gastric Mucosa/drug effects
- Gastric Mucosa/metabolism
- Gastric Mucosa/pathology
- Gene Expression Regulation
- Immobilization/methods
- Immobilization/psychology
- Inflammation
- Membrane Transport Proteins
- Mifepristone/pharmacology
- Mitochondria/drug effects
- Mitochondria/metabolism
- Mitochondria/pathology
- Mitochondrial Dynamics/drug effects
- Mitochondrial Dynamics/genetics
- Mitochondrial Precursor Protein Import Complex Proteins
- Mitochondrial Proteins/genetics
- Mitochondrial Proteins/metabolism
- Mitophagy/drug effects
- Mitophagy/genetics
- NF-kappa B/genetics
- NF-kappa B/metabolism
- Organophosphorus Compounds/pharmacology
- Oxidative Stress
- Piperidines/pharmacology
- Protein Kinases/genetics
- Protein Kinases/metabolism
- Rats, Sprague-Dawley
- Receptors, Cell Surface
- Receptors, Cytoplasmic and Nuclear/genetics
- Receptors, Cytoplasmic and Nuclear/metabolism
- Receptors, Glucocorticoid/antagonists & inhibitors
- Receptors, Glucocorticoid/genetics
- Receptors, Glucocorticoid/metabolism
- Stomach
- Stress, Psychological/genetics
- Stress, Psychological/metabolism
- Stress, Psychological/pathology
- Superoxides/metabolism
- Ubiquitin-Protein Ligases/genetics
- Ubiquitin-Protein Ligases/metabolism
- bcl-2-Associated X Protein/genetics
- bcl-2-Associated X Protein/metabolism
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Affiliation(s)
- Rudranil De
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Somnath Mazumder
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Souvik Sarkar
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Subhashis Debsharma
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Asim Azhar Siddiqui
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Shubhra Jyoti Saha
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Chinmoy Banerjee
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Shiladitya Nag
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Debanjan Saha
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Uday Bandyopadhyay
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India.
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5
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Romo-Nava F, Buijs FN, Valdés-Tovar M, Benítez-King G, Basualdo M, Perusquía M, Heinze G, Escobar C, Buijs RM. Olanzapine-induced early cardiovascular effects are mediated by the biological clock and prevented by melatonin. J Pineal Res 2017; 62. [PMID: 28226198 DOI: 10.1111/jpi.12402] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 02/17/2017] [Indexed: 01/07/2023]
Abstract
Second generation antipsychotics (SGA) are associated with adverse cardiometabolic side effects contributing to premature mortality in patients. While mechanisms mediating these cardiometabolic side effects remain poorly understood, three independent studies recently demonstrated that melatonin was protective against cardiometabolic risk in SGA-treated patients. As one of the main target areas of circulating melatonin in the brain is the suprachiasmatic nucleus (SCN), we hypothesized that the SCN is involved in SGA-induced early cardiovascular effects in Wistar rats. We evaluated the acute effects of olanzapine and melatonin in the biological clock, paraventricular nucleus and autonomic nervous system using immunohistochemistry, invasive cardiovascular measurements, and Western blot. Olanzapine induced c-Fos immunoreactivity in the SCN followed by the paraventricular nucleus and dorsal motor nucleus of the vagus indicating a potent induction of parasympathetic tone. The involvement of a SCN-parasympathetic neuronal pathway after olanzapine administration was further documented using cholera toxin-B retrograde tracing and vasoactive intestinal peptide immunohistochemistry. Olanzapine-induced decrease in blood pressure and heart rate confirmed this. Melatonin abolished olanzapine-induced SCN c-Fos immunoreactivity, including the parasympathetic pathway and cardiovascular effects while brain areas associated with olanzapine beneficial effects including the striatum, ventral tegmental area, and nucleus accumbens remained activated. In the SCN, olanzapine phosphorylated the GSK-3β, a regulator of clock activity, which melatonin prevented. Bilateral lesions of the SCN prevented the effects of olanzapine on parasympathetic activity. Collectively, results demonstrate the SCN as a key region mediating the early effects of olanzapine on cardiovascular function and show melatonin has opposing and potentially protective effects warranting additional investigation.
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Affiliation(s)
- Francisco Romo-Nava
- Hypothalamic Integration Mechanisms Laboratory, Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), México city, DF, México
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, UNAM, México city, DF, México
- Division of Bipolar Disorder Research, Department of Psychiatry and Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Frederik N Buijs
- Hypothalamic Integration Mechanisms Laboratory, Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), México city, DF, México
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, BA, The Netherlands
| | - Marcela Valdés-Tovar
- Laboratorio de Neurofarmacología, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México city, DF, México
| | - Gloria Benítez-King
- Laboratorio de Neurofarmacología, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México city, DF, México
| | - MariCarmen Basualdo
- Hypothalamic Integration Mechanisms Laboratory, Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), México city, DF, México
| | - Mercedes Perusquía
- Endocrinology of Reproduction Laboratory, Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas UNAM, México city, DF, México
| | - Gerhard Heinze
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, UNAM, México city, DF, México
| | - Carolina Escobar
- Departamento de Anatomía, Facultad de Medicina, UNAM, México city, DF, México
| | - Ruud M Buijs
- Hypothalamic Integration Mechanisms Laboratory, Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), México city, DF, México
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Hanlon FM, Shaff NA, Dodd AB, Ling JM, Bustillo JR, Abbott CC, Stromberg SF, Abrams S, Lin DS, Mayer AR. Hemodynamic response function abnormalities in schizophrenia during a multisensory detection task. Hum Brain Mapp 2015; 37:745-55. [PMID: 26598791 DOI: 10.1002/hbm.23063] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/20/2015] [Accepted: 11/12/2015] [Indexed: 11/07/2022] Open
Abstract
Functional magnetic resonance imaging (fMRI) of the blood oxygen level dependent (BOLD) response has commonly been used to investigate the neuropathology underlying cognitive and sensory deficits in patients with schizophrenia (SP) by examining the positive phase of the BOLD response, assuming a fixed shape for the hemodynamic response function (HRF). However, the individual phases (positive and post-stimulus undershoot (PSU)) of the HRF may be differentially affected by a variety of underlying pathologies. The current experiment used a multisensory detection task with a rapid event-related fMRI paradigm to investigate both the positive and PSU phases of the HRF in SP and healthy controls (HC). Behavioral results indicated no significant group differences during task performance. Analyses that examined the shape of the HRF indicated two distinct group differences. First, SP exhibited a reduced and/or prolonged PSU following normal task-related positive BOLD activation in secondary auditory and visual sensory areas relative to HC. Second, SP did not show task-induced deactivation in the anterior node of the default-mode network (aDMN) relative to HC. In contrast, when performing traditional analyses that focus on the positive phase, there were no group differences. Interestingly, the magnitude of the PSU in secondary auditory and visual areas was positively associated with the magnitude of task-induced deactivation within the aDMN, suggesting a possible common neural mechanism underlying both of these abnormalities (failure in neural inhibition). Results are consistent with recent views that separate neural processes underlie the two phases of the HRF and that they are differentially affected in SP. Hum Brain Mapp 37:745-755, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Faith M Hanlon
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico
| | - Nicholas A Shaff
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico
| | - Andrew B Dodd
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico
| | - Josef M Ling
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico
| | - Juan R Bustillo
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico.,Department of Neuroscience, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Christopher C Abbott
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Shannon F Stromberg
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Swala Abrams
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Denise S Lin
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Andrew R Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico.,Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico.,Department of Neurology, University of New Mexico School of Medicine, Albuquerque, New Mexico.,Department of Psychology, University of New Mexico, Albuquerque, New Mexico
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7
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Constantinos Z, Eleni P, Goulas A, Iakovidou-Kritsi Z. Olanzapine: evaluation of the in vivo cytogenetic effect. Hum Psychopharmacol 2015; 30:189-92. [PMID: 25787772 DOI: 10.1002/hup.2471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 03/02/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND/AIMS Olanzapine (OLZ), an atypical antipsychotic, is licensed for use in the treatment of schizophrenia and other psychiatric disorders. METHODS OLZ cytogenetic effects were investigated by evaluating the frequency of Sister Chromatid Exchanges (SCEs) and Proliferation Rate Index (PRI) in cultured lymphocytes of schizophrenic patients who were under treatment of OLZ. SCE estimation is one of the most sensitive biomarkers of potential cytotoxicity, while PRI is used as a valuable marker of cytostatic activity. RESULTS Our results showed a statistically significant increase of SCEs in the cultured lymphocytes of patients (p < 0,001) compared to the lymphocytes of healthy donors, a statistically significant increase of SCEs (p < 0.001) in the lymphocytes of smoker patients compared to those of non-smoker patients and a statistically significant increase of SCEs (p < 0.001) in the lymphocytes of chronic recipients of OLZ compared to those of the patients with recent initiation of treatment. We did not detect any statistically significant differences with respect to PRI between the various groups examined. CONCLUSIONS Our results indicate a mild cytotoxic-but not cytostatic-effect of OLZ which was more prominent in smokers and in chronically treated patients. That effect should be taken into consideration by psychiatrists upon assessing the benefit/risk ratio of their prescriptions.
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Affiliation(s)
- Zampas Constantinos
- Laboratory of General Biology and Genetics, Medical School, Aristotle University of Thessaloniki, Greece
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8
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Assessment of anti-arrhythmic activity of antipsychotic drugs in an animal model: Influence of non-cardiac α1-adrenergic receptors. Eur J Pharmacol 2015; 748:10-7. [DOI: 10.1016/j.ejphar.2014.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 11/28/2014] [Accepted: 12/10/2014] [Indexed: 01/09/2023]
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9
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Wu C, Yuen J, Boyda HN, Procyshyn RM, Wang CK, Asiri YI, Pang CCY, Honer WG, Barr AM. An evaluation of the effects of the novel antipsychotic drug lurasidone on glucose tolerance and insulin resistance: a comparison with olanzapine. PLoS One 2014; 9:e107116. [PMID: 25254366 PMCID: PMC4177840 DOI: 10.1371/journal.pone.0107116] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 08/13/2014] [Indexed: 11/30/2022] Open
Abstract
Over the past two decades, there has been a notable rise in the use of antipsychotic drugs, as they are used to treat an increasing number of neuropsychiatric disorders. This rise has been led predominantly by greater use of the second generation antipsychotic (SGA) drugs, which have a low incidence of neurological side-effects. However, many SGAs cause metabolic dysregulation, including glucose intolerance and insulin resistance, thus increasing the risk of cardiometabolic disorders. The metabolic effects of the novel SGA lurasidone, which was approved by the Food and Drug Administration in 2010, remain largely unknown. As rodent models accurately predict the metabolic effects of SGAs in humans, the aim of the present study was to use sophisticated animal models of glucose tolerance and insulin resistance to measure the metabolic effects of lurasidone. In parallel, we compared the SGA olanzapine, which has established metabolic effects. Adult female rats were treated with vehicle, lurasidone (0.2, 0.8 or 2.0 mg/kg, s.c.) or olanzapine (10.0 mg/kg, s.c.) and subjected to the glucose tolerance test (GTT). Separate groups of rats were treated with vehicle, lurasidone (0.2, 0.8 or 2.0 mg/kg, s.c.) or olanzapine (1.5 and 15 mg/kg, s.c.) and tested for insulin resistance with the hyperinsulinemic-euglycemic clamp (HIEC). Compared to vehicle treated animals, lurasidone caused mild glucose intolerance in the GTT with a single dose, but there was no effect on insulin resistance in the GTT, measured by HOMA-IR. The HIEC also confirmed no effect of lurasidone on insulin resistance. In contrast, olanzapine demonstrated dose-dependent and potent glucose intolerance, and insulin resistance in both tests. Thus, in preclinical models, lurasidone demonstrates mild metabolic liability compared to existing SGAs such as olanzapine. However, confirmation of these effects in humans with equivalent tests should be confirmed.
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Affiliation(s)
- Claire Wu
- Department of Pharmacology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jessica Yuen
- Department of Pharmacology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Heidi N. Boyda
- Department of Pharmacology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ric M. Procyshyn
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada
| | - Cathy K. Wang
- Department of Pharmacology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yahya I. Asiri
- Department of Pharmacology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Catherine C. Y. Pang
- Department of Pharmacology, University of British Columbia, Vancouver, British Columbia, Canada
| | - William G. Honer
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada
| | - Alasdair M. Barr
- Department of Pharmacology, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada
- * E-mail:
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10
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Fredrikson DH, Boyda HN, Tse L, Whitney Z, Pattison MA, Ott FJ, Hansen L, Barr AM. Improving metabolic and cardiovascular health at an early psychosis intervention program in vancouver, Canada. Front Psychiatry 2014; 5:105. [PMID: 25249985 PMCID: PMC4155777 DOI: 10.3389/fpsyt.2014.00105] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 08/04/2014] [Indexed: 12/13/2022] Open
Abstract
Psychotic disorders most commonly appear during the late teenage years and early adulthood. A focused and rapid clinical response by an integrated health team can help to improve the quality of life of the patient, leading to a better long-term prognosis. The Vancouver Coastal Health early psychosis intervention program covers a catchment area of approximately 800,000 people in the cities of Vancouver and Richmond, Canada. The program provides a multidisciplinary approach to supporting patients under the age of 30 who have recently experienced first-break psychosis. The program addresses the needs of the treatment environment, medication, and psychological therapies. A critical part of this support includes a program to specifically improve patients' physical health. Physical health needs are addressed through a two-pronged, parallel approach. Patients receive routine metabolic health assessments during their first year in the program, where standard metabolic parameters are recorded. Based on the results of clinical interviews and laboratory tests, specific actionable interventions are recommended. The second key strategy is a program that promotes healthy lifestyle goal development. Patients work closely with occupational therapists to develop goals to improve cardiometabolic health. These programs are supported by an active research environment, where patients are able to engage in studies with a focus on improving their physical health. These studies include a longitudinal evaluation of the effects of integrated health coaching on maintaining cardiometabolic health in patients recently admitted to the program, as well as a clinical study that evaluates the effects of low versus higher metabolic risk antipsychotic drugs on central adiposity. An additional pharmacogenomic study is helping to identify genetic variants that may predict cardiometabolic changes following treatment with antipsychotic drugs.
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Affiliation(s)
- Diane H Fredrikson
- Faculty of Medicine, University of British Columbia , Vancouver, BC , Canada ; Early Psychosis Intervention Program, Vancouver Coastal Health , Vancouver, BC , Canada
| | - Heidi N Boyda
- Faculty of Medicine, University of British Columbia , Vancouver, BC , Canada
| | - Lurdes Tse
- Faculty of Medicine, University of British Columbia , Vancouver, BC , Canada
| | - Zachary Whitney
- Faculty of Medicine, University of British Columbia , Vancouver, BC , Canada
| | - Mark A Pattison
- Early Psychosis Intervention Program, Vancouver Coastal Health , Vancouver, BC , Canada
| | - Fred J Ott
- Early Psychosis Intervention Program, Vancouver Coastal Health , Vancouver, BC , Canada
| | - Laura Hansen
- Early Psychosis Intervention Program, Vancouver Coastal Health , Vancouver, BC , Canada
| | - Alasdair M Barr
- Faculty of Medicine, University of British Columbia , Vancouver, BC , Canada
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