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Review
. 2018;16(8):1210-1223.
doi: 10.2174/1570159X15666170630163616.

Antipsychotic Drugs: From Receptor-binding Profiles to Metabolic Side Effects

Spyridon Siafis  1 , Dimitrios Tzachanis  1   2 , Myrto Samara  3 , Georgios Papazisis  1
Affiliations
Review

Antipsychotic Drugs: From Receptor-binding Profiles to Metabolic Side Effects

Spyridon Siafis et al. Curr Neuropharmacol. 2018.

Abstract

Background: Antipsychotic-induced metabolic side effects are major concerns in psychopharmacology and clinical psychiatry. Their pathogenetic mechanisms are still not elucidated.

Methods: Herein, we review the impact of neurotransmitters on metabolic regulation, providing insights into antipsychotic-induced metabolic side effects.

Results: Antipsychotic drugs seem to interfere with feeding behaviors and energy balance, processes that control metabolic regulation. Reward and energy balance centers in central nervous system constitute the central level of metabolic regulation. The peripheral level consists of skeletal muscles, the liver, the pancreas, the adipose tissue and neuroendocrine connections. Neurotransmitter receptors have crucial roles in metabolic regulation and they are also targets of antipsychotic drugs. Interaction of antipsychotics with neurotransmitters could have both protective and harmful effects on metabolism.

Conclusion: Emerging evidence suggests that antipsychotics have different liabilities to induce obesity, diabetes and dyslipidemia. However this diversity cannot be explained merely by drugs'pharmacodynamic profiles, highlighting the need for further research.

Keywords: Receptor-binding profiles; antipsychotics; diabetes; feeding behavior; metabolic regulation; metabolic side effects; neurotransmitters; obesity..

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Figures

Fig. (1)
Fig. (1)
Metabolic regulation and neurotransmitter receptors: the “canvas” of antipsychotic-induced metabolic dysfunctions. CNS and peripheral organs are the two major levels of metabolic regulation. They have bidirectional neuroendocrine connections and express neurotransmitter receptors. Energy balance (energy intake-energy expenditure), adipose tissue function, insulin secretion and insulin sensitivity are important sections of proper metabolic regulation. Antipsychotic drugs, by acting on neurotransmitter receptors, could alter this system and induce metabolic dysfunctions. (The color version of the figure is available in the electronic copy of the article).
See this image and copyright information in PMC

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