Title:Metabolomic Connections between Schizophrenia, Antipsychotic Drugs and Metabolic Syndrome: A Variety of Players
Volume: 27
Issue: 39
Author(s): Juan D. Molina, Sonia Avila, Gabriel Rubio and Francisco López-Muñoz*
Affiliation:
- Hospital 12 de Octubre Research Institute (i+12), Madrid,Spain
Keywords:
Schizophrenia, metabolic syndrome, metabolomics, second-generation antipsychotics, biomarker, gut microbiota, diagnosis.
Abstract:
Background: Diagnosis of schizophrenia lacks reliable medical diagnostic tests and robust biomarkers
applied to clinical practice. Schizophrenic patients undergoing treatment with antipsychotics suffer
reduced life expectancy due to metabolic disarrangements that co-exist with their mental illness and predispose
them to develop metabolic syndrome, which is also exacerbated by medication. Metabolomics is an emerging
and potent technology able to accelerate this biomedical research.
Aim: This review focus on a detailed vision of the molecular mechanisms involved both in schizophrenia and
antipsychotic-induced metabolic syndrome, based on innovative metabolites that consistently change in nascent
metabolic syndrome, drug-naïve, first episode psychosis and/or schizophrenic patients compared to healthy subjects.
Main Lines: Supported by metabolomic approaches, although not exclusively, noteworthy variations are reported
mainly through serum samples of patients and controls in several scenes: 1) alterations in fatty acids, inflammatory
response indicators, amino acids and biogenic amines, biometals, and gut microbiota metabolites
(schizophrenia); 2) alterations in metabolites involved in carbohydrate and gut microbiota metabolism, inflammation
and oxidative stress (metabolic syndrome), some of them shared with schizophrenia; 3) alterations of
cytokines secreted by adipose tissue, phosphatidylcholines, acylcarnitines, Sirtuin 1, orexin-A, and changes in
microbiota composition (antipsychotic-induced metabolic syndrome).
Conclusion: Novel insights into the pathogenesis of schizophrenia and metabolic side-effects associated with
its antipsychotic treatment represent an urgent request for scientists and clinicians. Leptin, carnitines, adiponectin,
insulin, or interleukin-6 represent some examples of candidate biomarkers. Cutting-edge technologies like
metabolomics have the power to strengthen research for achieving preventive, diagnostic, and therapeutical solutions
for schizophrenia.
