Neuroendocrine effects of a short-term osmotic stimulus in patients with chronic schizophrenia.
We studied the effects of a short-term hypertonic stimulus on plasma levels of the stress hormones adrenocorticotropin (ACTH), cortisol, prolactin, and the blood volume- and electrolyte-controlling hormones arginine vasopressin (AVP) and atrial natriuretic peptide (ANP). Seven patients suffering from chronic schizophrenia with negative symptoms and ten healthy control subjects were investigated by a 20-minute infusion of 10 ml/kg body weight of hypertonic (2.5%) versus isotonic (0.9%) saline. All patients, who were medication-free for at least one week prior to the study, and all control subjects participated in two investigations in randomized order according to a single-blind cross-over design. During hypertonic infusion, plasma osmolarity and sodium levels were increased similarly in both groups and significantly more than during isotonic saline. Hypertonic saline caused a significant increase of plasma ACTH, cortisol and prolactin in patients in contrast to controls. AVP and ANP plasma concentrations were elevated after infusion of hypertonic saline, however, only patients showed a significant rise in plasma ANP. These results show that a dysregulation of the hypothalamic-pituitary-adrenal (HPA) system in a subset of patients with chronic schizophrenia may become overt during an osmotic stimulation, indicating an increased sensitivity of patients with schizophrenia to osmotic stress.
Hundt
W
W
Department of Psychiatry and Psychotherapy, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Kellner
M
M
Wiedemann
K
K
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001127:Arginine Vasopressin / Q000097:blood; D009320:Atrial Natriuretic Factor / Q000097:blood; D002908:Chronic Disease; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000008:administration & dosage; D008297:Male; D009997:Osmotic Pressure; D011388:Prolactin / Q000097:blood; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000494:pharmacology*; D012559:Schizophrenia / Q000097:blood*; D016037:Single-Blind Method; D013997:Time Factors
D007552:Isotonic Solutions; D012462:Saline Solution, Hypertonic; D001127:Arginine Vasopressin; D009320:Atrial Natriuretic Factor; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D006854:Hydrocortisone