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Plasma levels of leptin and endogenous immune modulators during treatment with carbamazepine or lithium

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Abstract

Several psychopharmacological agents induce weight gain. Recent studies have suggested that the tumor necrosis factor-α (TNF-α) cytokine system is pathophysiologically involved. To assess whether carbamazepine and lithium, which have been reported to lead to weight gain, have effects on the circulating levels of cytokines, we measured plasma levels of TNF-α, its soluble receptors sTNF-R p55 and p75, and leptin, as well as weight in 25 inpatients receiving lithium (n=10) or carbamazepine (n=15) weekly during the first 4 weeks of treatment. We found an increase in the body mass index and in TNF-α and its soluble receptor levels, but not in leptin levels over the 4 weeks of treatment. These changes did not differ between treatment groups. Changes of weight during the first week of treatment, but no other parameter, strongly predicted weight change until endpoint. We conclude that the mood stabilizers carbamazepine and lithium have similar effects on the TNF-α system and do not affect leptin levels.

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References

  • Atmaca M, Kuloglu M, Tezcan E, Ustundag B (2002) Weight gain and serum leptin levels in patients on lithium. Neuropsychobiology 46:67–69

    Article  CAS  PubMed  Google Scholar 

  • Baptista T, Beaulieu S (2002) Are leptin and cytokines involved in body weight gain during treatment with antipsychotic drugs? Can J Psychiatry 47:742–749

    PubMed  Google Scholar 

  • Baptista T, Teneud L, Contreras Q, Alastre T, Burguera JL, de Burguera M, de Baptista E, Weiss S, Hernandez L (1995) Lithium and body weight gain. Pharmacopsychiatry 28:35–44

    CAS  PubMed  Google Scholar 

  • Bauer MS, Mitchner L (2004) What is a “mood stabilizer”? An evidence-based response. Am J Psychiatry 161:3–18

    Article  PubMed  Google Scholar 

  • Berghöfer A, Kossmann B, Müller-Oerlinghausen B (1996) Course of illness and pattern of recurrences in patients with affective disorders during long-term lithium prophylaxis: a retrospective analysis over 15 years. Acta Psychiatr Scand 93:349–354

    PubMed  Google Scholar 

  • Corman CL, Leung NM, Guberman AH (1997) Weight gain in epileptic patients during treatment with valproic acid: a retrospective study. Can J Neurol Sci 24:240–244

    CAS  PubMed  Google Scholar 

  • Haack M, Hinze-Selch D, Fenzel T, Kraus T, Kuhn M, Schuld A, Pollmächer T (1999) Plasma levels of cytokines and soluble cytokine receptors in psychiatric patients upon hospital admission: effects of confounding factors and diagnosis. J Psychiatr Res 33:407–418

    Article  CAS  PubMed  Google Scholar 

  • Himmerich H, Schuld A, Haack M, Kaufmann C, Pollmächer T (2004) Early prediction of changes in weight during six weeks of treatment with antidepressants. J Psychiatr Res 38:485–489

    Google Scholar 

  • Hinze-Selch D, Schuld A, Kraus T, Kühn M, Uhr M, Haack M, Pollmächer T (2000) Effects of antidepressants on weight and on the plasma levels of leptin, TNF- and soluble TNF receptors: a longitudinal study in patients treated with amitriptyline or paroxetine. Neuropsychopharmacology 23:13–19

    Article  CAS  PubMed  Google Scholar 

  • Hotamisligil GS, Shargill NS, Spiegelman BM (1993) Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science 259:87–91

    CAS  PubMed  Google Scholar 

  • Kraus T, Haack M, Schuld A, Hinze-Selch D, Kühn M, Uhr M, Pollmächer T (1999) Body weight and leptin plasma levels during treatment with antipsychotic drugs. Am J Psychiatry 156:312–314

    CAS  PubMed  Google Scholar 

  • Kraus T, Haack M, Schuld A, Hinze-Selch D, Koethe D, Pollmächer T (2002) Body weight, the tumor necrosis factor system and leptin production during treatment with mirtazapine or venlafaxine. Pharmacopsychiatry 35:220–225

    Article  CAS  PubMed  Google Scholar 

  • Lampl Y, Eshel Y, Rapaport A, Sarova-Pinhas I (1991) Weight gain, increased appetite, and excessive food intake induced by carbamazepine. Clin Neuropharmacol 14:251–255

    CAS  PubMed  Google Scholar 

  • Maes M, Song C, Lin AH, Pioli R, Kenis G, Kubera M, Bosmans E (1999) In vitro immunoregulatory effects of lithium in healthy volunteers. Psychopharmacology 143:401–407

    Article  CAS  PubMed  Google Scholar 

  • Malhi GS, Mitchell PB, Caterson I (2001) “Why getting fat, Doc?” Weight gain and psychotropic medications. Aust NZ J Psychiatry 35:315–321

    Article  CAS  Google Scholar 

  • McIntyre RS, Mancini DA, Basile VS, Srinivasan J, Kennedy SH (2003) Antipsychotic-induced weight gain: bipolar disorder and leptin. J Clin Psychopharmacol 23:323–327

    Google Scholar 

  • Melkersson K, Dahl ML (2004) Adverse metabolic effects associated with atypical antipsychotics: literature review and clinical implications. Drugs 64:701–723

    CAS  PubMed  Google Scholar 

  • Mendlewicz J, Souery D, Rivelli SK (1999) Short-term and long-term treatment for bipolar patients: beyond the guidelines. J Affect Disord 55:79–85

    Article  CAS  PubMed  Google Scholar 

  • Nemeroff CB (2003) Safety of available agents used to treat bipolar disorder: focus on weight gain. J Clin Psychiatry 64:532–539

    Google Scholar 

  • Pollmächer T, Hinze-Selch D, Mullington J (1996) Effects of clozapine on plasma cytokine and soluble cytokine receptor levels. J Clin Psychopharmacol 16:403–409

    Google Scholar 

  • Pollmächer T, Schuld A, Kraus T, Haack M, Hinze-Selch D (2001) Zur klinischen Relevanz der Wirkung von Clozapin auf die Freisetzung von Zytokinen und löslichen Zytokinrezeptoren. Fortschr Neurol Psychiatr 69(Suppl 2):65–74

    Article  Google Scholar 

  • Post RM, Denicoff KD, Frye MA, Dunn RT, Leverich GS, Osuch E, Speer A (1998) A history of the use of anticonvulsants as mood stabilizers in the last two decades of the 20th century. Neuropsychobiology 38:152–166

    Article  CAS  PubMed  Google Scholar 

  • Schou M, Baastrup PC, Grof P, Weiss P, Angst PJ (1970) Pharmacological and clinical problems of lithium prophylaxis. Br J Psychiatry 116:615–619

    CAS  PubMed  Google Scholar 

  • Schuld A, Kraus T, Haack M, Hinze-Selch D, Kühn M, Pollmächer T (2000) Plasma levels of cytokines and soluble cytokine receptors during treatment with olanzapine. Schizophr Res 102:1–3

    Google Scholar 

  • Schwartz MW, Woods SC, Porte DJ, Seeley RJ, Baskin DG (2000) Central nervous system control of food intake. Nature 404:661–671

    CAS  PubMed  Google Scholar 

  • Vasudev K, Goswami U, Kohli K (2000) Carbamazepine and valproate monotherapy: feasibility, relative safety and efficacy, and therapeutic drug monitoring in manic disorder. Psychopharmacology 150:15–23

    Article  CAS  PubMed  Google Scholar 

  • Vendsborg PB, Bech P, Rafaelsen OJ (1976) Lithium treatment and weight gain. Acta Psychiatr Scand 53:139–147

    CAS  PubMed  Google Scholar 

  • Vestergaard P, Amdisen A (1981) Lithium treatment and kidney function. A follow-up study of 237 patients in long-term treatment. Acta Psychiatr Scand 63:333–345

    CAS  PubMed  Google Scholar 

  • Walden J, Normann C, Langosch J, Grunze H (1999) Wirksamkeitspradiktoren fur Phasenprophylaktika (Stimmungsstabilisierer) bei bipolaren affektiven Störungen. Fortschr Neurol Psychiatr 67:75–80

    CAS  PubMed  Google Scholar 

  • Zhang ZJ, Yao ZJ, Liu W, Fang Q, Reynolds GP (2004) Effects of antipsychotics on fat deposition and changes in leptin and insulin levels. Magnetic resonance imaging study of previously untreated people with schizophrenia. Br J Psychiatry 184:58–62

    Article  PubMed  Google Scholar 

  • Zimmermann U, Kraus T, Himmerich H, Schuld A, Pollmächer T (2003) Epidemiology, implications and mechanisms underlying drug-induced weight gain in psychiatric patients. J Psychiatr Res 37:193–220

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank Ms. Irene Gunst and Ms. Gabriele Kohl for technical assistance, and Ms. Dorothea Skottke for assistance in preparing the manuscript.

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Correspondence to Thomas Pollmächer.

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Himmerich, H., Koethe, D., Schuld, A. et al. Plasma levels of leptin and endogenous immune modulators during treatment with carbamazepine or lithium. Psychopharmacology 179, 447–451 (2005). https://doi.org/10.1007/s00213-004-2038-9

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  • DOI: https://doi.org/10.1007/s00213-004-2038-9

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