Carbohydrate reward and psychosis: an explanation for neuroleptic induced weight gain and path to improved mental health?

Simon Thornley,Bruce Russell,Rob Kydd

doi:10.2174/157015911795596513

Simon Thornley, Bruce Russell + Show 1 more

Open Access

https://doi.org/10.2174/157015911795596513

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Journal: Current Neuropharmacology	Publication Date: Jun 1, 2011
Citations: 47	License type: cc-by

Affiliation: University of Auckland

Abstract

Evidence links dopamine release in the mid-brain to the pathophysiology of psychosis, addiction and reward. Repeated ingestion of refined carbohydrate may stimulate the same mesolimbic dopaminergic pathway, rewarding such eating behaviour and resulting in excessive food intake along with obesity. In this paper, we explore the role of dopamine in reward and psychosis, and discuss how reward pathways may contribute to the weight gain that commonly follows antipsychotic drug use, in people with psychotic illness. Our theory also explains the frequent co-occurrence of substance abuse and psychosis. From our hypothesis, we discuss the use of carbohydrate modified diets as an adjunctive treatment for people with psychosis.

Highlights

The mesolimbic dopaminergic system of the mid brain is intimately linked to two major categories of disease (1) addiction, and (2) psychotic disorders
We argue that food intake shares clinical features of addiction; especially the consumption of sugars and refined carbohydrates
Amphetamine induced dopamine release is exaggerated in people with schizophrenia; second, after amphetamine administration, dopamine release is associated with psychotic symptoms; and third, these changes in dopaminergic physiology in people with schizophrenia have been detected in patients never treated with antipsychotic drugs [32]

Summary

Introduction

The mesolimbic dopaminergic system of the mid brain is intimately linked to two major categories of disease (1) addiction, and (2) psychotic disorders. We first consider theoretical and observed links between psychosis and addiction, postulate a new hypothesis, which may explain the weight gain that commonly occurs after antipsychotic drug use [2,3,4,5]. Anatomical changes found following Positron Emission Tomography studies of those who suffer from drug addiction show evidence of adaptation, with an increased concentration of dopamine receptors compared to controls [25].

Results

Conclusion