Can melatonin prevent or improve metabolic side effects during antipsychotic treatments?

Maria-Cristina Porfirio,1 Juliana Paula Gomes de Almeida,2 Maddalena Stornelli,1 Silvia Giovinazzo,1 Diane Purper-Ouakil,3 Gabriele Masi4 1Unit of Child Neurology and Psychiatry, “Tor Vergata” University of Rome, Italy; 2Unit of Child Neurology, Irmandade Santa Casa de Misericor...

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Autores principales:	Porfirio MC, Gomes de Almeida JP, Stornelli M, Giovinazzo S, Purper-Ouakil D, Masi G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	melatonin metabolic syndrome secondary generation antipsychotics Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/b2e81848dc3c4431a9dd600c5a4dd880
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spelling	oai:doaj.org-article:b2e81848dc3c4431a9dd600c5a4dd8802021-12-02T02:43:00ZCan melatonin prevent or improve metabolic side effects during antipsychotic treatments?1178-2021https://doaj.org/article/b2e81848dc3c4431a9dd600c5a4dd8802017-08-01T00:00:00Zhttps://www.dovepress.com/can-melatonin-prevent-or-improve-metabolic-side-effects-during-antipsy-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Maria-Cristina Porfirio,1 Juliana Paula Gomes de Almeida,2 Maddalena Stornelli,1 Silvia Giovinazzo,1 Diane Purper-Ouakil,3 Gabriele Masi4 1Unit of Child Neurology and Psychiatry, “Tor Vergata” University of Rome, Italy; 2Unit of Child Neurology, Irmandade Santa Casa de Misericordia Hospital São Paulo, Brazil; 3Unit of Child and Adolescent Psychiatry, Saint Eloi Hospital, Montpellier, France; 4IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy Abstract: In the last two decades, second-generation antipsychotics (SGAs) were more frequently used than typical antipsychotics for treating both psychotic and nonpsychotic psychiatric disorders in both children and adolescents, because of their lower risk of adverse neurological effects, that is, extrapyramidal symptoms. Recent studies have pointed out their effect on weight gain and increased visceral adiposity as they induce metabolic syndrome. Patients receiving SGAs often need to be treated with other substances to counteract metabolic side effects. In this paper, we point out the possible protective effect of add-on melatonin treatment in preventing, mitigating, or even reversing SGAs metabolic effects, improving quality of life and providing safer long-term treatments in pediatric patients. Melatonin is an endogenous indolamine secreted during darkness by the pineal gland; it plays a key role in regulating the circadian rhythm, generated by the suprachiasmatic nuclei (SCN) of the hypothalamus, and has many other biological functions, including chronobiotic, antioxidant and neuroprotective properties, anti-inflammatory and free radical scavenging effects, and diminishing oxidative injury and fat distribution. It has been hypothesized that SGAs cause adverse metabolic effects that may be restored by nightly administration of melatonin because of its influence on autonomic and hormonal outputs. Interestingly, atypical anti-psychotics (AAPs) can cause several sleep disorders, and circadian misalignment can influence hormones involved in the metabolic regulation, such as insulin, leptin, and ghrelin; furthermore, a relationship between obesity and sleep curtailment has been demonstrated, as well as sleep deprivation in rats has been associated with hyperphagia. Metabolic effects of melatonin, both central and peripheral, direct and indirect, target most metabolic disorders reported during and after SGA treatment in children, adolescents, and adults. Further systematic studies on psychiatric patients are needed to explore the effect of add-on melatonin on metabolic side effects of SGAs, independent of energy intake, diet, and exercise. Keywords: melatonin, metabolic syndrome, second-generation antipsychoticsPorfirio MCGomes de Almeida JPStornelli MGiovinazzo SPurper-Ouakil DMasi GDove Medical Pressarticlemelatoninmetabolic syndromesecondary generation antipsychoticsNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 2167-2174 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	melatonin metabolic syndrome secondary generation antipsychotics Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	melatonin metabolic syndrome secondary generation antipsychotics Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Porfirio MC Gomes de Almeida JP Stornelli M Giovinazzo S Purper-Ouakil D Masi G Can melatonin prevent or improve metabolic side effects during antipsychotic treatments?
description	Maria-Cristina Porfirio,1 Juliana Paula Gomes de Almeida,2 Maddalena Stornelli,1 Silvia Giovinazzo,1 Diane Purper-Ouakil,3 Gabriele Masi4 1Unit of Child Neurology and Psychiatry, “Tor Vergata” University of Rome, Italy; 2Unit of Child Neurology, Irmandade Santa Casa de Misericordia Hospital São Paulo, Brazil; 3Unit of Child and Adolescent Psychiatry, Saint Eloi Hospital, Montpellier, France; 4IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy Abstract: In the last two decades, second-generation antipsychotics (SGAs) were more frequently used than typical antipsychotics for treating both psychotic and nonpsychotic psychiatric disorders in both children and adolescents, because of their lower risk of adverse neurological effects, that is, extrapyramidal symptoms. Recent studies have pointed out their effect on weight gain and increased visceral adiposity as they induce metabolic syndrome. Patients receiving SGAs often need to be treated with other substances to counteract metabolic side effects. In this paper, we point out the possible protective effect of add-on melatonin treatment in preventing, mitigating, or even reversing SGAs metabolic effects, improving quality of life and providing safer long-term treatments in pediatric patients. Melatonin is an endogenous indolamine secreted during darkness by the pineal gland; it plays a key role in regulating the circadian rhythm, generated by the suprachiasmatic nuclei (SCN) of the hypothalamus, and has many other biological functions, including chronobiotic, antioxidant and neuroprotective properties, anti-inflammatory and free radical scavenging effects, and diminishing oxidative injury and fat distribution. It has been hypothesized that SGAs cause adverse metabolic effects that may be restored by nightly administration of melatonin because of its influence on autonomic and hormonal outputs. Interestingly, atypical anti-psychotics (AAPs) can cause several sleep disorders, and circadian misalignment can influence hormones involved in the metabolic regulation, such as insulin, leptin, and ghrelin; furthermore, a relationship between obesity and sleep curtailment has been demonstrated, as well as sleep deprivation in rats has been associated with hyperphagia. Metabolic effects of melatonin, both central and peripheral, direct and indirect, target most metabolic disorders reported during and after SGA treatment in children, adolescents, and adults. Further systematic studies on psychiatric patients are needed to explore the effect of add-on melatonin on metabolic side effects of SGAs, independent of energy intake, diet, and exercise. Keywords: melatonin, metabolic syndrome, second-generation antipsychotics
format	article
author	Porfirio MC Gomes de Almeida JP Stornelli M Giovinazzo S Purper-Ouakil D Masi G
author_facet	Porfirio MC Gomes de Almeida JP Stornelli M Giovinazzo S Purper-Ouakil D Masi G
author_sort	Porfirio MC
title	Can melatonin prevent or improve metabolic side effects during antipsychotic treatments?
title_short	Can melatonin prevent or improve metabolic side effects during antipsychotic treatments?
title_full	Can melatonin prevent or improve metabolic side effects during antipsychotic treatments?
title_fullStr	Can melatonin prevent or improve metabolic side effects during antipsychotic treatments?
title_full_unstemmed	Can melatonin prevent or improve metabolic side effects during antipsychotic treatments?
title_sort	can melatonin prevent or improve metabolic side effects during antipsychotic treatments?
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/b2e81848dc3c4431a9dd600c5a4dd880
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Can melatonin prevent or improve metabolic side effects during antipsychotic treatments?

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