Neuroendocrine response to antipsychotics: effects of drug type and gender.
BACKGROUND
To study the influences of drug type and gender on the neuroendocrine response to neuroleptic treatment, we compared the endocrine actions of two neuroleptics with different receptor affinity profiles--a substituted benzamide, amisulpride, a selective D2-like dopamine antagonist; and a thioxanthene, flupenthixol, a mixed D1/D2-like antagonist also blocking serotonin, H1, and D1 receptors--on anterior pituitary hormone secretion in schizophrenic patients (DSM-III-R).


METHODS
Blood was withdrawn at 15-min intervals to assess basal secretion of prolactin, growth hormone (GH), and thyroid-stimulating hormone (TSH). Four hundred micrograms of thyrotropin-releasing hormone (TRH) was injected i.v. to investigate drug effects on TRH-stimulated secretion of prolactin, TSH, and GH.


RESULTS
Prolactin plasma levels were markedly elevated in both treatment groups. In female, but not in male patients, this elevation was significantly more pronounced under amisulpride than under flupenthixol. The prolactin response to TRH was significantly blunted by amisulpride only in male subjects. While basal TSH secretion was significantly increased by both compounds, TRH-stimulated TSH secretion was elevated only in patients treated with amisulpride. Low basal prolactin levels predicted improvement of negative symptoms in patients treated with amisulpride.


CONCLUSIONS
Amisulpride's more pronounced endocrine effects may be a reflection of its distinguished pharmacology and pharmacokinetics.
Gründer
G
G
Department of Psychiatry, University of Mainz, Germany.
Wetzel
H
H
Schlösser
R
R
Anghelescu
I
I
Hillert
A
A
Lange
K
K
Hiemke
C
C
Benkert
O
O
D000328:Adult; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005475:Flupenthixol / Q000009:adverse effects / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D008297:Male; D009490:Neurosecretory Systems / Q000187:drug effects*; D011388:Prolactin / Q000097:blood; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy; D012565:Schizophrenic Psychology; D012737:Sex Factors; D013469:Sulpiride / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D013972:Thyrotropin / Q000097:blood
D014150:Antipsychotic Agents; D019382:Human Growth Hormone; D013469:Sulpiride; D000077582:Amisulpride; D011388:Prolactin; D013972:Thyrotropin; D005475:Flupenthixol