Metabolic syndrome and psychotropic medications

Psychiatric Clinic, Clinical Hospital Centre Osijek, Croatia.
Medicinski glasnik (Impact Factor: 0.2). 08/2012; 9(2):180-8.
Source: PubMed


Metabolic syndrome represents a cluster of interrelated metabolic dysfunctions which are risk factors for the development of diabetes and cardiovascular disease. Results of clinical studies suggest significant effects of certain psychotropic medications on weight gain and manifestation of type II diabetes. The psychoactive drugs may influence weight gain through increased food consumption and disruption of satiety signaling system. Some psychoactive medications cause weight increase, insulin resistance, dyslipidemia, impairment glucose tolerance/ type II diabetes and hypertension. Dyslipidemia and increase of insulin resistance can be collateral or a direct consequence of psychoactive drug actions. The authors have reviewed accessible literature throughout electronic databases ten years aback in order to estimate prevalence of metabolic syndrome in the mentally ill, give an overview of accomplishments in researching pathophysiology of metabolic syndrome and effects of psychotropic drugs on apparition and pathophysiological mechanisms in causing mentioned syndrome. Finally, the authors consolidated guidelines and references for prevention and treatment of patients with metabolic syndrome induced by psychotropic drugs.

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    ABSTRACT: The organic anion transporter (OAT) subfamily, which constitutes roughly half of the SLC22 (solute carrier 22) transporter family, has received a great deal of attention because of its role in handling of common drugs (antibiotics, antivirals, diuretics, nonsteroidal anti-inflammatory drugs), toxins (mercury, aristolochic acid), and nutrients (vitamins, flavonoids). Oats are expressed in many tissues, including kidney, liver, choroid plexus, olfactory mucosa, brain, retina, and placenta. Recent metabolomics and microarray data from Oat1 [Slc22a6, originally identified as NKT (novel kidney transporter)] and Oat3 (Slc22a8) knockouts, as well as systems biology studies, indicate that this pathway plays a central role in the metabolism and handling of gut microbiome metabolites as well as putative uremic toxins of kidney disease. Nuclear receptors and other transcription factors, such as Hnf4α and Hnf1α, appear to regulate the expression of certain Oats in conjunction with phase I and phase II drug metabolizing enzymes. Some Oats have a strong selectivity for particular signaling molecules, including cyclic nucleotides, conjugated sex steroids, odorants, uric acid, and prostaglandins and/or their metabolites. According to the "Remote Sensing and Signaling Hypothesis," which is elaborated in detail here, Oats may function in remote interorgan communication by regulating levels of signaling molecules and key metabolites in tissues and body fluids. Oats may also play a major role in interorganismal communication (via movement of small molecules across the intestine, placental barrier, into breast milk, and volatile odorants into the urine). The role of various Oat isoforms in systems physiology appears quite complex, and their ramifications are discussed in the context of remote sensing and signaling. Copyright © 2015 the American Physiological Society.
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