The hypothalamic-pituitary-adrenal axis in chronic schizophrenic patients long-term treated with neuroleptics

Purpose: The authors investigated the hypothalamic-pituitary-adrenal (HPA) axis of regularly medicated schizophrenic patients. Methods: The subjects were 53 patients who were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) criteria for schizophrenia. Each patient gave informed consent for the research. Psychiatric symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). Based on the dosages of neuroleptics (NLPs), the subjects were classified into two groups: those with lower dosages (LD) and those with higher dosages (HD). Findings: (a) The medicated schizophrenic patients had significantly higher plasma corticotropin (ACTII) levels than the normals. (b) There was no significant difference in plasma cortisol levels between the schizophrenic patients and normals. (c) There was a significant difference in plasma ACTH levels between the HD and normal groups, but not between the LD and normal groups. (d) There was no significant difference in administration periods of NLPs, positive (POS) or negative symptoms (NES) between the HD and LD groups. (e) There was a positive correlation between the plasma ACTH and plasma cortisol levels in patients. Conclusions: Our results showed that, in chronic schizophrenic patients long-term treated with NLPs, ACTH secretion was elevated. (C) 2002 Elsevier Science Inc. All rights reserved.