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Neuroendocrine changes in acute schizophrenia as a function of clinical state and neuroleptic medication

Published online by Cambridge University Press:  09 July 2009

P. Mary Cotes ,
T. J. Crow ,
Eve C. Johnstone ,
W. Bartlett  and
Rachel C. Bourne
P. Mary Cotes*
Affiliation:
Division of Psychiatry and Division of Clinical Chemistry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
T. J. Crow
Affiliation:
Division of Psychiatry and Division of Clinical Chemistry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
Eve C. Johnstone
Affiliation:
Division of Psychiatry and Division of Clinical Chemistry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
W. Bartlett
Affiliation:
Division of Psychiatry and Division of Clinical Chemistry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
Rachel C. Bourne
Affiliation:
Division of Psychiatry and Division of Clinical Chemistry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
*
1Address for correspondence: Dr P. Mary Cotes, Division of Clinical Chemistry, Clinical Research Centre, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ.
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Synopsis

Changes in levels of prolactin, growth hormone, luteinizing hormone, and follicle stimulating hormone in serum, and testosterone in plasma, have been studied in 38 patients with acute schizophrenic illnesses in a 4-week double-blind comparison of the 2 isomers of flupenthixol and placebo. Only prolactin showed changes which could be related either to changes in clinical state or to the effects of medication. Prolactin levels increased during treatment with the therapeutically active α-isomer of flupenthixol but were unchanged with the inactive β-isomer and placebo. Although there was a significant relationship between prolactin level and antipsychotic effect in patients on α-flupenthixol, in the individual case prolactin level was not a strong predictor of therapeutic response; and in patients on inactive medication changes in prolactin level could not be related to symptom change. There was a time lag of at least 2 weeks between the increase in prolactin secretion in patients on α-flupenthixol and the therapeutic effect attributable to medication. This delay suggests that if the antipsychotic effect is dependent upon dopamine receptor blockade it is not a direct consequence of this action. Perhaps dopamine receptor blockade permits other, and slower, changes to take place and it is these changes, rather than dopamine receptor blockade itself, which are reflected in clinical improvement.

Type
Research Article
Information
Psychological Medicine , Volume 8 , Issue 4 , November 1978 , pp. 657 - 665
Copyright
Copyright © Cambridge University Press 1978

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