Тиреоидная функция до и после лечения психотического эпизода

Background
Endocrine function in psychiatric patients may be affected by mental disorder itself as well as by antipsychotic medications.
The aim of this naturalistic observational study was to determine if treatment of acute psychotic episode with antipsychotic medication affects thyroid axis hormone concentrations and if such changes are associated with symptomatic improvement.
Methods
Eighty six adult acute psychotic patients, consecutively admitted to a mental hospital, were recruited for the study. All patients were physically healthy and without thyroid disease. During the hospitalization period all study patients received treatment with antipsychotic medication according to clinical need. Severity of the psychotic episode was evaluated using the Brief Psychiatric Rating Scale (BPRS) and venous blood samples were drawn for analysis of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) concentrations on the day of admission and on the day of discharge from the hospital.
Results
Antipsychotic drug treatment was associated with decrease of mean FT3 (p < 0.001) and FT4 (p = 0.002) concentrations; and with increase of mean TSH (p = 0.016) concentrations. Changes in thyroid hormone concentrations were mostly predicted by baseline hormone concentrations. Individual changes were not limited to decrease in high hormone concentrations; in patients who had low FT3 or FT4 concentrations, treatment resulted in increase in concentrations. Such an increase was established in one-quarter of patients for FT3 concentrations and in one-third of patients for FT4 concentrations. Fall in FT4 concentrations negatively correlated with the improvement in the BPRS score (r = −0.235, p = 0.023).
Conclusions
The study indicates that antipsychotic treatment resulted in a decrease in mean FT3 concentrations and in an increase in mean TSH concentrations after recovery from acute psychosis. Symptomatic improvement was less evident in patients who experienced a decrease in FT4 concentrations.

 Thyroid axis function after in-patient treatment of acute psychosis with antipsychotics: a naturalistic study

Влияние различных гормонов на симптомы шизофрении

The relationship between androgens and mental state seems particularly complicated. Animal evidence suggests that testosterone may be propsychotic, given that administration of testosterone significantly enhanced NMDA antagonist-induced disruptions in prepulse inhibition in OVX rats. There is also limited evidence that high-dose androgenic steroids can induce psychiatric symptoms in humans; however, most of the research to date into androgens and mental state has focused on the testosterone precursors dehydroepiandrosterone and DHEA-sulfate (DHEA-S). DHEA(S) is neuroprotective in the rodent brain, and differences in DHEA(S) blood levels between psychotic patients and healthy controls are widely reported; however, the direction of these differences is far from consistent. Results from clinical studies trialling DHEA(S) as an augmentation strategy have been similarly contradictory, with some studies finding a modest treatment effect and others reporting no superiority over placebo. Further research is needed. Pregnenolone and its metabolites pregnenolone sulfate and allopregnanolone seem more promising. In addition to also possessing neuromodulatory and neuroprotective properties, these neurosteroids exert positive effects in rodent models of cognition and psychosis.Serum levels of pregnenolone have been found to be lower in patients with schizophrenia than in healthy controls, and antipsychotic medications can significantly increase pregnenolone levels in the brain. A review of three small pilot studies investigating pregnenolone as an adjunctive intervention for patients with schizophrenia reports that pregnenolone was able to improve psychotic and cognitive symptoms, paving the way for future research into this compound. Recently, oxytocin has also emerged as possibly having an influence on mental state after one study found that higher peripheral oxytocin levels were associated with decreased symptom severity in women with chronic schizophrenia, and another study demonstrated efficacy of intranasal oxytocin as an adjunctive therapy in a randomized, cross-over sample of 15 schizophrenia patients.

 Hormones and Schizophrenia

Бисфенол А, эндокринная дисфункция и патогенез шизофрении

In recent years, numerous substances have been identified as so-called ‘‘endocrine disruptors’’ because exposure to them results in disruption of normal endocrine function with possible adverse health outcomes. The pathologic and behavioral abnormalities attributed to exposure to endocrine disruptors like bisphenol-A (BPA) have been studied in animals. Mental conditions ranging from cognitive impairment to autism have been linked to BPA exposure by more than one investigation. Concurrent with these developments in BPA research, schizophrenia research has continued to find evidence of possible endocrine or neuroendocrine involvement in the disease. Sufficient information now exists for a comparison of the neurotoxicological and behavioral pathology associated with exposure to BPA and other endocrine disruptors to the abnormalities observed in schizophrenia. This review summarizes these findings and proposes a theory of endocrine disruption, like that observed from BPA exposure, as a pathway of schizophrenia pathogenesis

BPA is a common ingredient of many plastic and resin products including food and drink containers, internal linings of food cans, and dental enamels. Also known as 2,2-bis(4-hydroxyphenyl) propane, BPA was invented in the 20th century and is manufactured by combining acetone and phenol. Emerging research indicates BPA is an estrogenic EDC that alters or interferes with normal endocrine development in various vertebrate and invertebrate species.

Effects of Bisphenol-A and Other Endocrine Disruptors Compared With Abnormalities of Schizophrenia: An Endocrine-Disruption Theory of Schizophrenia