Abstract
There is no doubt that chronic stress accompanied by adrenocortical stress hormone release affects the development and treatment outcome of several mental disorders. Less attention has been paid to the effects of psychotropic drugs on adrenocortical steroids, particularly in clinical studies. This review focuses on the knowledge related to the possible modulation of cortisol and aldosterone secretion under non-stress and stress conditions by antipsychotic drugs, which are being used in the treatment of several psychotic and affective disorders. The molecular mechanisms by which antipsychotic drugs may influence steroid stress hormones include the modulation of central and/or adrenocortical dopamine and serotonin receptors, modulation of inflammatory cytokines, influence on regulatory mechanisms in the central part of the hypothalamic-pituitary axis, inhibition of corticotropin-releasing hormone gene promoters, influencing glucocorticoid receptor-mediated gene transcription, indirect effects via prolactin release, alteration of signaling pathways of glucocorticoid and mineralocorticoid actions. Clinical studies performed in healthy subjects, patients with psychosis, and patients with bipolar disorder suggest that single and repeated antipsychotic treatments either reduce cortisol concentrations or do not affect its secretion. A single and potentially long-term treatment with dopamine receptor antagonists, including antipsychotics, has a stimulatory action on aldosterone release.
Highlights
Stress is unequivocally considered to be a significant contributing factor in the development and course of mental disorders
This review focuses on knowledge related to the possible modulation of cortisol and aldosterone secretion under non-stress and stress conditions by antipsychotic drugs and lithium, wanhdicahldaorseteursoende isnectrheetiotrneautnmdeenr tnoonf -ssetvreesrsaal npdsysctrheostsiccoanndditaiofnfescbtiyvaendtiipsosyrdcheorsti.c drugs and lithium, which are used in the treatment of several psychotic and affective disorders
Consistent with the above-mentioned effect of haloperidol, a single oral administration of the atypical antipsychotic drug olanzapine resulted in lower serum/plasma cortisol concentrations [67,74]
Summary
Stress is unequivocally considered to be a significant contributing factor in the development and course of mental disorders. The main steroid stress hormones, namely, glucocorticoids and mineralocorticoids, are produced and released into the circulation by the adrenal cortex. These stress hormones, represented by the mineralocorticoid aldosterone and the glucocorticoid cortisol. The main steroid stress hormones, namely, glucocorticoids and mineralocorticoi2dosf, are produced and released into the circulation by the adrenal cortex. These stress hormones, represented by the mineralocorticoid aldosterone and the glucocorticoid cortisol (corticosterone in rodents), are crucial for many brain and somatic functions in health and di(sceoarsteic.oBsotethrocneenitnrarloadnedntps)e,raiprehecrrualcimalefcohramniasnmysbpraarinticainpdatseoimn athtiec fruegnuctliaotniosninofhecoalrtthisaonl d aabacgondnlydaatrhUatdtrhirdnnoteioenoehsrrdrdnraedpieemrlsoopaneaedircrcsoilr[looetoeed3npuhclssa.r]eoeoittiot.sBttaersirerua(cUerstotAmraeiosieotcyntsrlChnfaoaoodv(erchlTnfcnHeyoi(yeeHasrheHnPpnvey(h)sdscAPtAoi,ptyearriAtra)atcCeophehnirlt)toaoasTieydhaasoxlnttHpaahnxiinfiscsmoloaid),.aon,s,nltAm,iaCnawhpa.cwmldaConeilhCccylirrhdiToaitciotcicirprmiHocfrhspoetihhtinolnriocieacietslsoarsiiarlo,stpciltsasasullrAoouoeylolnittsrnmCscprshrdtidotcaeiTterieecophellcmHrc-ereuriecrhatcxuteilti-shreaasahellrceextnoaelceeiussaeltuiolocesscelcc(ntaiomoscauion,stvnonsritttgtseioirhtttirnvrmitrinphesioopggec,oaoullgaaotrplhrolelrorstmda(aotiriftfcgctserorooheoihtgrmstpsfnirohietogtgaeoentretifhhthchrsne(erteooeCee)ehternsirhflRnhe(taerbeeeCboyHlarhtdrrrrmpsaRhoyea)eoeio.eHlnipnlsentoCetetrohha)acfee)R.tcesaesraghCfeeHenlodaruaan.nRtodormlletTremeaaHefrrenhemtirsaacrinso,eotcrde–,ihcmaehnclpsromelea–eeeiearogcptsncaedtsuhflriiodtdaeicetiehcact.unoritsoaeatoeitdTierortrtntradetshyhoatnainidr–pese[-lbty3ooieyc]–fl-. Uncertain whether these receptors are the target of antipsychotic drugs
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