TY - JOUR
T1 - Antipsychotic use is associated with a blunted cortisol stress response
T2 - a study in euthymic bipolar disorder patients and their unaffected siblings
AU - Houtepen, L C
AU - Boks, M P M
AU - Kahn, R S
AU - Joëls, M
AU - Vinkers, C H
N1 - Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.
PY - 2015/1
Y1 - 2015/1
N2 - There is ample evidence that the acute stress response is altered in schizophrenia and bipolar disorder. However, it is not clear whether such changes are related to the illness, a genetic vulnerability, or is the result of medication that is used in the majority of these patients. Therefore, we investigated determinants of the acute endocrine and autonomic stress response in healthy controls (n=48), euthymic BD1 patients (n=49) and unaffected siblings of BD1 patients (n=27). All participants completed a validated psychosocial stress task, the Trier Social Stress Test for Groups (TSST-G). Saliva levels of alpha-amylase and cortisol were measured before, during, and after exposure to stress. Compared to controls, we found a significantly blunted cortisol stress response in BD1 patients. Conversely, BD1 patients displayed exaggerated alpha-amylase levels in response to stress. Antipsychotic use was a significant contributing factor to the blunted cortisol stress response in BD1 patients. Unaffected BD1 siblings displayed similar stress-induced cortisol and alpha-amylase levels as controls, suggesting that familial risk for BD1 did not have a large effect on the functionality of the stress system. In conclusion, this study shows that euthymic BD1 patients have a substantially blunted endocrine stress response but an exaggerated autonomic stress response and that the endocrine stress response differences can be largely contributed to antipsychotic use rather than constitute a specific BD1 phenotype or vulnerability.
AB - There is ample evidence that the acute stress response is altered in schizophrenia and bipolar disorder. However, it is not clear whether such changes are related to the illness, a genetic vulnerability, or is the result of medication that is used in the majority of these patients. Therefore, we investigated determinants of the acute endocrine and autonomic stress response in healthy controls (n=48), euthymic BD1 patients (n=49) and unaffected siblings of BD1 patients (n=27). All participants completed a validated psychosocial stress task, the Trier Social Stress Test for Groups (TSST-G). Saliva levels of alpha-amylase and cortisol were measured before, during, and after exposure to stress. Compared to controls, we found a significantly blunted cortisol stress response in BD1 patients. Conversely, BD1 patients displayed exaggerated alpha-amylase levels in response to stress. Antipsychotic use was a significant contributing factor to the blunted cortisol stress response in BD1 patients. Unaffected BD1 siblings displayed similar stress-induced cortisol and alpha-amylase levels as controls, suggesting that familial risk for BD1 did not have a large effect on the functionality of the stress system. In conclusion, this study shows that euthymic BD1 patients have a substantially blunted endocrine stress response but an exaggerated autonomic stress response and that the endocrine stress response differences can be largely contributed to antipsychotic use rather than constitute a specific BD1 phenotype or vulnerability.
KW - Adult
KW - Aged
KW - Analysis of Variance
KW - Antipsychotic Agents/therapeutic use
KW - Bipolar Disorder/drug therapy
KW - Female
KW - Heart Rate/drug effects
KW - Humans
KW - Hydrocortisone/blood
KW - Male
KW - Middle Aged
KW - Psychiatric Status Rating Scales
KW - Saliva/drug effects
KW - Siblings/psychology
KW - Stress, Psychological/complications
KW - Surveys and Questionnaires
KW - Time Factors
KW - Young Adult
KW - alpha-Amylases/metabolism
U2 - 10.1016/j.euroneuro.2014.10.005
DO - 10.1016/j.euroneuro.2014.10.005
M3 - Article
C2 - 25453485
VL - 25
SP - 77
EP - 84
JO - European Neuropsychopharmacology
JF - European Neuropsychopharmacology
SN - 0924-977X
IS - 1
ER -