Sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profiles
Abstract Autonomic adverse effects of antipsychotic drugs (APs) cause clinical challenges, but few studies have investigated sex differences and their underlying biological pathways. Sex-specific regulation of relevant hormones could be involved. We investigated sex differences in autonomic adverse...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2024-01-01
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| Series: | Schizophrenia |
| Online Access: | https://doi.org/10.1038/s41537-023-00430-4 |
| _version_ | 1797363199193907200 |
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| author | Ingrid T. Johansen Nils Eiel Steen Linn Rødevand Synve H. Lunding Gabriela Hjell Monica B. E. G. Ormerod Ingrid Agartz Ingrid Melle Trine V. Lagerberg Mari Nerhus Ole A. Andreassen |
| author_facet | Ingrid T. Johansen Nils Eiel Steen Linn Rødevand Synve H. Lunding Gabriela Hjell Monica B. E. G. Ormerod Ingrid Agartz Ingrid Melle Trine V. Lagerberg Mari Nerhus Ole A. Andreassen |
| author_sort | Ingrid T. Johansen |
| collection | DOAJ |
| description | Abstract Autonomic adverse effects of antipsychotic drugs (APs) cause clinical challenges, but few studies have investigated sex differences and their underlying biological pathways. Sex-specific regulation of relevant hormones could be involved. We investigated sex differences in autonomic adverse effects related to olanzapine, quetiapine, risperidone, and aripiprazole, and the role of hormones related to APs. Patients with severe mental disorders (N = 1318) were included and grouped based on AP monotherapy: olanzapine (N = 364), quetiapine (N = 211), risperidone (N = 102), aripiprazole (N = 138), and no AP (N = 503). Autonomic symptoms from the Udvalg for Kliniske Undersøgelser (UKU) side effect scale was analyzed with logistic regression, adjusting for age, diagnosis, and polypharmacy. Further, we analyzed associations between autonomic symptoms and hormones related to APs. We found associations between autonomic adverse effects and APs, with sex-specific risk for palpitations/tachycardia associated with hormonal changes related to APs. Results showed increased salivation associated with aripiprazole, reduced salivation with quetiapine, and nausea/vomiting and palpitations/tachycardia with olanzapine, and higher risk of nausea/vomiting, diarrhea, constipation, polyuria/polydipsia, and palpitations/tachycardia in females. Significant sex x AP interaction was found for palpitations/tachycardia, with higher risk in risperidone-treated males, which was associated with different hormone profiles of prolactin, cortisol, and insulin. Our findings implicate a role of several hormones in the sex-specific autonomic adverse effects related to APs. |
| first_indexed | 2024-03-08T16:17:48Z |
| format | Article |
| id | doaj.art-e2f2bf315088455ea4cd446ec94ec028 |
| institution | Directory Open Access Journal |
| issn | 2754-6993 |
| language | English |
| last_indexed | 2024-03-08T16:17:48Z |
| publishDate | 2024-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Schizophrenia |
| spelling | doaj.art-e2f2bf315088455ea4cd446ec94ec0282024-01-07T12:30:44ZengNature PortfolioSchizophrenia2754-69932024-01-011011810.1038/s41537-023-00430-4Sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profilesIngrid T. Johansen0Nils Eiel Steen1Linn Rødevand2Synve H. Lunding3Gabriela Hjell4Monica B. E. G. Ormerod5Ingrid Agartz6Ingrid Melle7Trine V. Lagerberg8Mari Nerhus9Ole A. Andreassen10NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of OsloNORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of OsloNORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of OsloNORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of OsloNORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of OsloNORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of OsloNORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of OsloNORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of OsloNORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of OsloDivision of Health Services Research and Psychiatry, Institute of Clinical Medicine, University of Oslo Campus AhusNORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of OsloAbstract Autonomic adverse effects of antipsychotic drugs (APs) cause clinical challenges, but few studies have investigated sex differences and their underlying biological pathways. Sex-specific regulation of relevant hormones could be involved. We investigated sex differences in autonomic adverse effects related to olanzapine, quetiapine, risperidone, and aripiprazole, and the role of hormones related to APs. Patients with severe mental disorders (N = 1318) were included and grouped based on AP monotherapy: olanzapine (N = 364), quetiapine (N = 211), risperidone (N = 102), aripiprazole (N = 138), and no AP (N = 503). Autonomic symptoms from the Udvalg for Kliniske Undersøgelser (UKU) side effect scale was analyzed with logistic regression, adjusting for age, diagnosis, and polypharmacy. Further, we analyzed associations between autonomic symptoms and hormones related to APs. We found associations between autonomic adverse effects and APs, with sex-specific risk for palpitations/tachycardia associated with hormonal changes related to APs. Results showed increased salivation associated with aripiprazole, reduced salivation with quetiapine, and nausea/vomiting and palpitations/tachycardia with olanzapine, and higher risk of nausea/vomiting, diarrhea, constipation, polyuria/polydipsia, and palpitations/tachycardia in females. Significant sex x AP interaction was found for palpitations/tachycardia, with higher risk in risperidone-treated males, which was associated with different hormone profiles of prolactin, cortisol, and insulin. Our findings implicate a role of several hormones in the sex-specific autonomic adverse effects related to APs.https://doi.org/10.1038/s41537-023-00430-4 |
| spellingShingle | Ingrid T. Johansen Nils Eiel Steen Linn Rødevand Synve H. Lunding Gabriela Hjell Monica B. E. G. Ormerod Ingrid Agartz Ingrid Melle Trine V. Lagerberg Mari Nerhus Ole A. Andreassen Sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profiles Schizophrenia |
| title | Sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profiles |
| title_full | Sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profiles |
| title_fullStr | Sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profiles |
| title_full_unstemmed | Sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profiles |
| title_short | Sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profiles |
| title_sort | sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profiles |
| url | https://doi.org/10.1038/s41537-023-00430-4 |
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