Impaired hormonal regulation of appetite in schizophrenia: A narrative review dissecting intrinsic mechanisms and the effects of antipsychotics.

Psychoneuroendocrinology
Michał LisBłażej Misiak

Abstract

Cardiometabolic diseases are the main contributor of reduced life expectancy in patients with schizophrenia. It is now widely accepted that antipsychotic treatment plays an important role in the development of obesity and its consequences. However, some intrinsic mechanisms need to be taken into consideration. One of these mechanisms might be related to impaired hormonal regulation of appetite in this group of patients. In this narrative review, we aimed to dissect impairments of appetite-regulating hormones attributable to intrinsic mechanisms and those related to medication effects. Early hormonal alterations that might be associated with intrinsic mechanisms include low levels of leptin and glucagon-like peptide-1 (GLP-1) together with elevated insulin levels in first-episode psychosis (FEP) patients. However, evidence regarding low GLP-1 levels in FEP patients is based on one large study. In turn, multiple-episode schizophrenia patients show elevated levels of insulin, leptin and orexin A together with decreased levels of adiponectin. In addition, patients receiving olanzapine may present with low ghrelin levels. Post mortem studies have also demonstrated reduced number of neuropeptide Y neurons in the prefrontal cortex of ...Continue Reading

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Citations

Dec 15, 2020·The International Journal of Neuropsychopharmacology·Yutaka MizukiNorihito Yamada
May 12, 2021·Schizophrenia Bulletin·Jing LuAi-Min Bao
Jul 19, 2021·Progress in Neuro-psychopharmacology & Biological Psychiatry·Błażej MisiakDorota Frydecka
Dec 24, 2020·Nutrients·Nicolette StogiosMargaret K Hahn
Aug 6, 2021·Current Pharmaceutical Design·Juan D MolinaFrancisco López-Muñoz

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