Severe psychosis and the adrenal androgens

Howard, James S.

doi:10.1007/bf02690893

Cited by 14 publications

(5 citation statements)

References 15 publications

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“…Since there is theoretical possibility that DHEA may exacerbate symptoms of psychosis in schizophrenia or result in disinhibition, aggression, overactivation, and mania, [32][33][34] observations from this preliminary investigation suggest the safety of DHEA administration in this subpopulation. Of the 15 patients randomized to receive DHEA, only 1 had to be withdrawn prematurely from the study owing to early clinical deterioration.…”

Section: Commentmentioning

confidence: 77%

“…Furthermore, psychosis associated with DHEA has been reported with endogenous productions of DHEA in severely androgenized females, in whom endocrine testing revealed very high levels of DHEA, unlike those found in our study. 34 There is the theoretical potential for DHEA to exacerbate hormone-sensitive tumors by virtue of its metabolism to testosterone and estrogen. 15 Despite close monitoring of patients in the hospital, no evidence of any of these above adverse effects were noted in subjects participating in the study.…”

Section: Commentmentioning

confidence: 99%

See 1 more Smart Citation

Dehydroepiandrosterone Augmentation in the Management of Negative, Depressive, and Anxiety Symptoms in Schizophrenia

Strous¹,

Maayan²,

Lapidus³

et al. 2003

Arch Gen Psychiatry

189

104

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Section: Commentmentioning

confidence: 77%

Section: Commentmentioning

confidence: 99%

Dehydroepiandrosterone Augmentation in the Management of Negative, Depressive, and Anxiety Symptoms in Schizophrenia

Strous¹,

Maayan²,

Lapidus³

et al. 2003

Arch Gen Psychiatry

189

104

View full text Add to dashboard Cite

show abstract

“…Although it has been reported that plasma levels of these steroids do not differ between patients with schizophrenia and controls (Brophy et al, 1983;Harris et al, 2001;Shirayama et al, 2002), older studies reported reduced plasma DHEA concentrations in schizophrenics (Tourney and Hatfield, 1972;Oertel et al, 1974), particularly in the morning (Tourney and Erb, 1979). More recent studies, arguably more accurate (due to improved methodological techniques), have reported elevated plasma levels of DHEA and DHEAS in severely psychotic male subjects (Howard, 1992), medicated patients with chronic schizophrenia (Oades and Schepker, 1994;di Michele et al, 2005) and in nonmedicated first-episode patients compared to controls. Abnormal plasma diurnal rhythms of DHEA, but not DHEAS, were observed in schizophrenia such that patients were distinguished from controls with 100% accuracy (Erb et al, 1981).…”

Section: Neuroactive Steroids In Schizophreniamentioning

confidence: 98%

The Relevance of Neuroactive Steroids in Schizophrenia, Depression, and Anxiety Disorders

et al. 2007

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1. Neuroactive steroids are steroid hormones that exert rapid, nongenomic effects at ligand-gated ion channels. There is increasing awareness of the possible role of these steroids in the pathology and manifestation of symptoms of psychiatric disorders. The aim of this paper is to review the current knowledge of neuroactive steroid functioning in the central nervous system, and to assess the role of neuroactive steroids in the pathophysiology and treatment of symptoms of schizophrenia, depression, and anxiety disorders. Particular emphasis will be placed on GABAA receptor modulation, given the extensive knowledge of the interactions between this receptor complex, neuroactive steroids, and psychiatric illness. 2. A brief description of neuroactive steroid metabolism is followed by a discussion of the interactions of neuroactive steroids with acute and chronic stress and the HPA axis. Preclinical and clinical studies related to psychiatric disorders that have been conducted on neuroactive steroids are also described. 3. Plasma concentrations of some neuroactive steroids are altered in individuals suffering from schizophrenia, depression, or anxiety disorders compared to values in healthy controls. Some drugs used to treat these disorders have been reported to alter plasma and brain concentrations in clinical and preclinical studies, respectively. 4. Further research is warranted into the role of neuroactive steroids in the pathophysiology of psychiatric illnesses and the possible role of these steroids in the successful treatment of these disorders.

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“…Abnormalities in the conversion of DHEA to DHEAS have also been implicated in SZ. The earlier studies reporting decreased plasma DHEA levels in SZ patients ( 146 , 147 ) were questionable due to methodology issues. However, the later studies with improved methodology have shown elevated levels of plasma DHEA and DHEAS in severely psychotic male subjects ( 148 ), chronic SZ patients under treatment ( 149 ), and first-episode drug-naïve patients ( 150 ).…”

Section: Potential Roles Of Neurosteroids In Szmentioning

confidence: 94%

Neurosteroids in Schizophrenia: Pathogenic and Therapeutic Implications

et al. 2018

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Neurosteroids are a group of important endogenous molecules affecting many neural functions in the brain. Increasing evidence suggests a possible role of these neurosteroids in the pathology and symptomatology of schizophrenia (SZ) and other mental disorders. The aim of this review is to summarize the current knowledge about the neural functions of neurosteroids in the brain, and to evaluate the role of the key neurosteroids as candidate modulators in the etiology and therapeutics of SZ. The present paper provides a brief introduction of neurosteroid metabolism and distribution, followed by a discussion of the mechanisms underlying neurosteroid actions in the brain. The content regarding the modulation of the GABAA receptor is elaborated, given the considerable knowledge of its interactions with other neurotransmitter and neuroprotective systems, as well as its ameliorating effects on stress that may play a role in the SZ pathophysiology. In addition, several preclinical and clinical studies suggested a therapeutic benefit of neurosteroids in SZ patients, even though the presence of altered neurosteroid pathways in the circulating blood and/or brain remains debatable. Following treatment of antipsychotic drugs in SZ, therapeutic benefits have also been linked to the regulation of neurosteroid signaling. Specifically, the neurosteroids such as pregnenolone and dehydroepiandrosterone affect a broad spectrum of behavioral functions through their unique molecular characteristics and may represent innovative therapeutic targets for SZ. Future investigations in larger cohorts with long-term follow-ups will be required to ascertain the neuropsychopharmacological role of this yet unexploited class of neurosteroid agents.

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Severe psychosis and the adrenal androgens

Cited by 14 publications

References 15 publications

Dehydroepiandrosterone Augmentation in the Management of Negative, Depressive, and Anxiety Symptoms in Schizophrenia

Dehydroepiandrosterone Augmentation in the Management of Negative, Depressive, and Anxiety Symptoms in Schizophrenia

The Relevance of Neuroactive Steroids in Schizophrenia, Depression, and Anxiety Disorders

Neurosteroids in Schizophrenia: Pathogenic and Therapeutic Implications

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