The hypothalamic-pituitary-adrenal axis in chronic schizophrenic patients long-term treated with neuroleptics.
OBJECTIVE
The authors investigated the hypothalamic-pituitary-adrenal (HPA) axis of regularly medicated schizophrenic patients.


METHODS
The subjects were 53 patients who were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV) criteria for schizophrenia. Each patients gave informed consent for the research. Psychiatric symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). Based on the dosages of neuroleptics (NLPs), the subjects were classified into two groups: those with lower dosages (LD) and those with higher dosages (HD).


RESULTS
(a) The medicated schizophrenic patients had significantly higher plasma corticotropin (ACTH) levels than the normals. (b) There was no significant difference in plasma cortisol levels between the schizophrenic patients and normals. (c) There was a significant difference in plasma ACTH levels between the HD and normal groups, but not between the LD and normal groups. (d) There was no significant difference in administration periods of NLPs, positive (POS) or negative symptoms (NES) between the HD and LD groups. (e) There was a positive correlation between the plasma ACTH and plasma cortisol levels in patients.


CONCLUSIONS
Our results showed that, in chronic schizophrenic patients long-term treated with NLPs, ACTH secretion was elevated.
D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000378:metabolism; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000187:drug effects* / Q000378:metabolism; D012559:Schizophrenia / Q000097:blood* / Q000188:drug therapy; D018709:Statistics, Nonparametric
D014150:Antipsychotic Agents; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone