10. 10. 2007
Prague Psychiatric Centre & Charles University, 3rd Faculty of Medicine, Ustavni 91, 181 03 Praha 8, Czech Republic
Although antipsychotics of the second generation (AP2G) are to a certain degree associated with metabolic risk factors including weight gain and alterations in lipid and glucose metabolism, the disease itself (schizophrenia) may also be associated with an increased risk of diabetes mellitus type 2 in comparison with the general population. Moreover, conventional antipsychotics, especially phenothiazines, were also reported to impair glucose tolerance and to aggravate pre-existing DM. Possible diabetogenic mechanism of AP2G may involve direct influence on pancreatic beta-cells via 5HT1A/2A/2C receptors, alpha2 functions or muscarinic M3 receptors as well as weight gain due to H1 and/or 5HT2C antagonism. Other possibilities involve blockade of glucose transporter, increase of leptin etc. Our published data on the relationship between central serotonin turnover and insulin sensitivity will be briefly presented.
Schwenkreis P. and Assion H.-J.: Atypical antipsychotics and Diabetes mellitus. World J Biol Psychiatry 2004, 5;2:73-82.
Horáček J., Kuzmiaková M., Höschl C., Anděl M., Bahbouh R.: The relationship between central serotonergic activity and insulin sensitivity in healthy volunteers. Psychoneuroendocrinology 24;1999:785-797.
Horáček J., Bubeníková-Valešová V., Kopeček M., Páleníček T., Dockery C., Mohr P., Höschl C.: Mechanism of action of atypical antipsychotic drugs and the neurobiology of schizophrenia. CNS Drugs. 20, 2006; 5:389-409.