Antipsychotika und Phospholipidmetabolismus bei der Schizophrenie

Abstract

To date numerous in-vivo (31)P-MRS and in-vitro studies in schizophrenic patients have been able to demonstrate changes in their membrane phospholipid metabolism, which might be relevant for the cause and the therapeutic responsiveness of this disorder. Thus far, however, only limited studies exist regarding the specificity of these findings for schizophrenia and the effect of antipsychotic medication. The present study examined the composition of membrane phospholipids in platelets of 67 neuroleptic-free schizophrenic patients compared to healthy and psychiatric controls. In a subsample of the schizophrenic patients we determined the effect of antipsychotic treatment on the phospholipid metabolism during six-months follow up. While untreated patients showed a decrease in major membrane phospholipid components, i.e. phosphatidylcholine and phosphatidylethanolamine, when compared to control subjects, as well as an increase in their breakdown-product lysophosphatidylcholine (LPC), there was a significant reduction in LPC during three weeks of pharmacotherapy with haloperidol. After six months treatment with different antipsychotics some divergent effects on phospholipid metabolism in schizophrenic patients could be demonstrated. While in the long-term course LPC remained decreased under continuous therapy with typical neuroleptics, patients being treated with the atypical drug zotepine showed an increase in LPC compared to their baseline level before therapy. Thus, specific mechanisms of the different antipsychotic therapies on phospholipid metabolism might serve to explain the divergent findings of (31)P-MRS in medicated patients.

Metabolic biomarkers of risperidone-induced weight gain in drug-naïve patients with schizophrenia

“…This may be due to the different distribution of C-1 and C-2 positions of fatty acids with different lengths and saturation in glycerophosphate, leading to the different performance of the metabolite. Moreover, elevated TG levels may be the earliest and most sensitive indicator of the metabolic abnormalities associated with antipsychotics ( 26 ). Studies demonstrated the treatment with risperidone also elevated concentrations of TG ( 24 , 27 ), which is consistent with our results.…”

Beneficial Effects of Fish Oil on Human Brain

“…Elevated levels of lyso-PtdCho in schizophrenic patients are significantly reduced after 3 weeks of pharmacotherapy with haloperidol (Schmitt et al, 2001). This effect of haloperidol is caused by a dopamine-mediated decrease in PLA 2 activity.…”

Determinação de fosfolípides plasmáticos nas doenças neuropsiquiátricas

“…Com isso, podem-se adotar tratamentos mais específicos de acordo com o prognóstico, visando a melhoria na qualidade de vida do paciente (Schneider et al, 2016). (Senaratne et al, 2009) e também um aumento de PC nas regiões corticais e subcorticais (Weber-Fahr et al, 2013), diminuição de PC no tálamo (Schmitt et al, 2001) e no lobo caudado (Yao et al, 2000) de pacientes com SCZ. Um estudo descreveu um aumento de AGs e PCs em pacientes com TB e SCZ em relação a controles saudáveis, tanto em tecido post mortem (substância branca e cinzenta) e glóbulos vermelhos (Schwarz et al, 2008).…”

“…As diferenças nos achados se mantêm em matrizes periféricas. McEvoy e colegas (2013) encontraram uma diminuição de AG, mas não de PC em plasma de pacientes com SCZ, já em plaquetas foi descrito uma diminuição de PC (Schmitt et al, 2001).…”