Delayed Action of Insulin in Schizophrenia

Braceland, Francis J.; Meduna, L. J.; Vaichulis, J. A.

doi:10.1176/ajp.102.1.108

Cited by 121 publications

(55 citation statements)

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“…Abnormal glucose regulation in schizophrenia has been reported over much of the last century [e.g., Kooy, 1919;Braceland et al, 1945;Franzen and Nilsson, 1968]. Between 1930s and 1950s (when neuroleptics were introduced), insulin coma therapy was a treatment of choice for schizophrenia [Cramond, 1987].…”

Section: Introductionmentioning

confidence: 99%

“…It is significant, however, that recent animal studies suggest the mechanisms of insulin therapy action may include modulation of dopamine neurotransmission in a manner similar to that produced by typical neuroleptic medications [Lozovsky et al, 1985]. Moreover, numerous studies report either impaired glucose tolerance or increased resistance to insulin in schizophrenia [e.g., Braceland et al, 1945;Franzen and Nilsson, 1968;Schimmelbusch et al, 1971;Brambilla et al, 1976], or relationships between fasting levels of glucose or insulin, and abnormal movements or tardive dyskinesia [Ganzini et al, 1991;Schultz et al, 1999].…”

Section: Introductionmentioning

confidence: 99%

“…Interestingly, impaired glucose regulation is not limited to an association with the newer pharmacological treatments. Some of the earlier observations in this area were made before neuroleptic treatments were introduced [e.g., Braceland et al, 1945], or later, in un-medicated patients [Schimmelbusch et al, 1971] and in patients treated with typical neuroleptic medications [e.g., Mukherjee et al, 1989].…”

Section: Introductionmentioning

confidence: 99%

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Evidence for linkage between regulatory enzymes in glycolysis and schizophrenia in a multiplex sample

Stone

Faraone

et al. 2003

American J of Med Genetics Pt B

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Observations of impaired glucose regulation in schizophrenia are long-standing, although their pathological and etiological significance is uncertain. One approach to the issue that minimizes environmental variables (e.g., medication and diet) is to determine whether genes related to glucose regulation show genetic linkage to schizophrenia. We examined the potential role of glucose metabolism in schizophrenia through a genome scan of affection status in schizophrenia and an empirical method for deriving P-values. Data were utilized from the NIMH Genetics Initiative for Schizophrenia dataset, which comprises a total sample consisting of 71 pedigrees containing 218 nuclear families and 987 individuals. A genome scan with 459 markers spaced at an average of 10 cM intervals was conducted using the linkage analysis program Genehunter separately for European- and African-American groups. Enzymes that regulate glycolysis were identified and the genes regulating these enzymes were located through the Online Mendelian Inheritance in Man (OMIM) website. The focus in this study was on genes located near previously reported schizophrenia susceptibility regions. The genome-wide significance of these genes to schizophrenia was assessed using permutation testing. When results were adjusted for multiple testing within and across ethnic groups, 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 2 (PFKFB2; chromosome 1q32.2) achieved genome-wide significance (P = 0.04). In addition, hexokinase 3 (HK3; chromosome 5q35.3) was also suggestive of linkage (P = 0.09). For the European-American sample, PFKFB2 (1q32.2), hexokinase 3 (HK3; 5q35.3), and pyruvate kinase 3 (PK3; chromosome 15q23) achieved significance at the 0.05 level. None of the genes showed significance in the African-American sample. Our results provide further support for the view that genes that regulate glucose metabolism may also influence susceptibility to schizophrenia. More generally, they support the view that relationships between glucose dysregulation and schizophrenia are inherent to the disorder, and are not merely epiphenomena related to medication or other treatment factors.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evidence for linkage between regulatory enzymes in glycolysis and schizophrenia in a multiplex sample

Stone

Faraone

et al. 2003

American J of Med Genetics Pt B

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“…(Regenold et al, 2000) It is difficult to determine whether schizophrenia per se has an independent role in the development of abnormal glucose metabolism, as both conventional and atypical neuroleptics have been implicated in the pathogenesis of T2DM and impaired glucose tolerance (Mir and Taylor, 2001;Liebzeit et al, 2001;Lindenmayer et al, 2001). Prior to the www.intechopen.com introduction of the first modern antipsychotics in the 1950's, several studies suggested that schizophrenia was associated with an increased risk of diabetes (Lorenz, 1922, Meduna et al, 1942, Braceland et al, 1945, Freeman, 1946, Langfeldt, 1952, Robinson and Shelton, 1940. Unfortunately, those studies did not use explicit diagnostic criteria for schizophrenia, and potentially confounding factors such as body mass index (BMI) and smoking were not considered.…”

Section: Psychiatric Medications Predisposing To Dmmentioning

confidence: 99%

“…While regulatory agencies have failed at times to provide specific monitoring recommendations or guidance regarding differential risk for hyperglycemia or DM among various AAP, consensus guidelines are now being published which elaborate on the differences in risk between agents, and provide rational monitoring schemes (American Diabetes Association et al, 2004;and Marder et al, 2004) Historical evidence of abnormal glucose metabolism in psychiatric patients has been accumulating since the early 20th century (Kooy, 1919). The evidence consists of numerous reports of increased rates of impaired glucose tolerance, insulin resistance, and frank diabetes mellitus among psychiatric patients (Braceland, 1945;Waitzkin, 1966;Mueller, 1969;Keskiner, 1973;Brambilla, 1976 andWinokur, 1988). Eaton et al (1996), following up on individuals who had been diagnosed with major depression in 1981, found that major depression was associated with a 2.23 relative risk of diabetes onset over the 13 years since diagnosis.…”

Section: Psychiatric Medications Predisposing To Dmmentioning

confidence: 99%

The Bidirectional Relationship Between Psychiatry and Type 2 Diabetes Mellitus

Rabie¹

2011

Topics in the Prevention, Treatment and Complications of Type 2 Diabetes

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Resistance to Insulin in Mentally Disturbed Soldiers

Freeman¹

1946

Arch NeurPsych

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PREVIOUS investigators1 have noted abnormalities in the carbohydrate metabolism of psychotic persons. Their studies have concentrated chiefly on the response of the blood sugar to ingested dextrose, and have revealed that there exists a reduction in the dextrose tolerance, with resulting diabetic-like levels of blood sugar. To determine whether this abnormal trend is due to a dysfunction of the insulinogenic mechanisms, Freemanla and Braceland1c investigated the insulin tolerance of schizophrenic subjects and found that such patients show a less pronounced fall in blood sugar after the administration of insulin than do normal subjects.In order to determine whether resistance to insulin is a characteristic feature of the schizophrenic psychosis alone, I made a study of this function in other mental disorders. METHOD AND MATERIALThe subjects included 93 soldiers discharged from the Army for psychiatric disorders. The average age of the patients lay between 20 and 25. Their nutrition was on the whole good, the average nutritional index being 98 per cent of the ideal (according to standards of the Metropolitan Insurance Company). Few were grossly overweight or underweight. The average stay in the Army before psy¬ chiatric symptoms appeared was six months. Each patient had been confined in a mental disease hospital in the military service for an average of two months before the present study. These patients showed many varieties of psychiatric symptoms, although in general the clinical status showed less clearly defined and more transitory types of disturbance than are ordinarily found· in the civilian population.The technic of the test was simple. After a postabsorptive period of at least fourteen hours, a control sample of blood was taken, and insulin was then administered intravenously in a dose of 0.1 unit per kilogram of body weight. Subsequent samples of blood were taken at regular thirty minute intervals, with the patient lying quietly in bed.

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Delayed Action of Insulin in Schizophrenia

Cited by 121 publications

References 0 publications

Evidence for linkage between regulatory enzymes in glycolysis and schizophrenia in a multiplex sample

Evidence for linkage between regulatory enzymes in glycolysis and schizophrenia in a multiplex sample

The Bidirectional Relationship Between Psychiatry and Type 2 Diabetes Mellitus

Resistance to Insulin in Mentally Disturbed Soldiers

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