Leptin and psychiatric illnesses: does leptin play a role in antipsychotic-induced weight gain?

Francky Teddy Endomba,Aurel T Tankeu,Jan René Nkeck,Joel Noutakdie Tochie

doi:10.1186/s12944-020-01203-z

Abstract

Antipsychotic-induced weight gain is the most prevalent somatic adverse event occurring in patients treated by antipsychotics, especially atypical antipsychotics. It is of particular interest because of its repercussion on cardiovascular morbidity and mortality especially now that the use of second-generation antipsychotics has been extended to other mental health illnesses such as bipolar disorders and major depressive disorder. The mechanism underlying antipsychotics-induced weight gain is still poorly understood despite a significant amount of work on the topic. Recently, there has been an on-going debate of tremendous research interest on the relationship between antipsychotic-induced weight gain and body weight regulatory hormones such as leptin. Given that, researchers have brought to light the question of leptin’s role in antipsychotic-induced weight gain. Here we summarize and discuss the existing evidence on the link between leptin and weight gain related to antipsychotic drugs, especially atypical antipsychotics.

Highlights

Due to their various neurobiological actions, secondgeneration antipsychotics (SGAs) known as atypical antipsychotics are increasingly used for the management of other mental disorders such as schizophrenia and related psychotic disorders [1, 2]
In their study published in 2005, Haupt and colleagues argued against a role for defective leptin secretion, clearance, or signaling in the body weight gain induced by antipsychotics [84]
Despite the huge amount of evidence elucidated from good-quality studies, the correlation between leptin and Conclusion According to current existing literature, elevated serum leptin levels in psychiatric patients treated by antipsychotics, mainly Second generation antipsychotics (SGAs), tend to be recognized as the consequence of the underlying mental disorders and/or antipsychotics induced weight gain, but not to be the cause of body weight gain

Summary

Introduction

Due to their various neurobiological actions, secondgeneration antipsychotics (SGAs) known as atypical antipsychotics are increasingly used for the management of other mental disorders such as schizophrenia and related psychotic disorders [1, 2]. The exact mechanism of weight gain appears to be a more complex association of various neurobiological and metabolic pathways [14] Aside from these widespread and well-known theories on the pathophysiology of AIWG, there is growing interest in the implication of hormones involved in the food intake process, such as leptin [14, 15]. Identified 25 years ago, leptin (from the Greek leptos, meaning thin), greatly changed the perception of the adipocytes as storage cells [16, 17] This 16-kDa peptide hormone predominantly secreted by adipocytes can reduce or suppress food intake and thereby induces weight loss [16, 17].

Basics on antipsychotics and leptin

Findings

Conclusion