title: Cortisol/dehydroepiandrosterone ratio and responses to antipsychotic treatment in schizophrenia.
abstract: Dehydroepiandrosterone (DHEA) or their sulfate conjugate (DHEAS) (together abbreviated DHEA(S)) exert multiple effects in the central nervous system, and may be involved in the pathophysiological processes in schizophrenia. This prospective study aimed to investigate whether serum cortisol/DHEA(S) molar ratios are associated with response to antipsychotic treatment during the exacerbation of schizophrenia. Serum DHEA(S) and cortisol were determined at baseline, and 2 and 4 weeks later for 43 medicated schizophrenia inpatients with acute exacerbation. The patients were treated with stable doses of antipsychotic agents up to 2 weeks prior to entering the study and for the 4-week duration of the study after which they were classified as either responders or nonresponders to treatment. Findings suggest that responders had significantly higher serum cortisol levels and cortisol/DHEA(S) ratios compared with nonresponders. These differences remained significant at three time points controlling for gender, age, severity of symptoms and emotional distress, benzodiazepines, type or dosage of antipsychotic agents, and background variables. The logistic regression model shows advantages of both cortisol/DHEA(S) molar ratios vs serum cortisol and DHEA(S) concentrations for prediction of responsivity to antipsychotic treatment. No significant canonical correlations were observed between changes from baseline through end-of-study in hormonal values and severity of symptoms and emotional distress among responders and nonresponders. Thus, these data provide evidence that elevated serum cortisol and cortisol/DHEA(S) ratios may serve as markers of biological mechanisms that are involved in responsivity of schizophrenia patients to antipsychotic treatment.
authors.affiliation: Sha'ar Menashe Mental Health Center, Mobile Post Hefer, 38814 Hadera, Israel. ritsner@shaar-menashe.org.il
authors.forename: Michael
authors.initials: M
authors.lastname: Ritsner
authors.forename: Anatoly
authors.initials: A
authors.lastname: Gibel
authors.forename: Rachel
authors.initials: R
authors.lastname: Maayan
authors.forename: Yael
authors.initials: Y
authors.lastname: Ratner
authors.forename: Edward
authors.initials: E
authors.lastname: Ram
authors.forename: Hassan
authors.initials: H
authors.lastname: Biadsy
authors.forename: Ilan
authors.initials: I
authors.lastname: Modai
authors.forename: Abraham
authors.initials: A
authors.lastname: Weizman
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003687:Dehydroepiandrosterone / Q000097:blood*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011863:Radioimmunoassay / Q000379:methods; D012559:Schizophrenia / Q000097:blood* / Q000188:drug therapy; D013997:Time Factors
chemical_list: D014150:Antipsychotic Agents; D003687:Dehydroepiandrosterone; D006854:Hydrocortisone