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Melatonin attenuates antipsychotic metabolic effects: an eight‐week randomized, double‐blind, parallel‐group, placebo‐controlled clinical trial
Author(s) -
RomoNava Francisco,
AlvarezIcaza González Dení,
FresánOrellana Ana,
Saracco Alvarez Ricardo,
BecerraPalars Claudia,
Moreno Julia,
Ontiveros Uribe Martha P,
Berlanga Carlos,
Heinze Gerhard,
Buijs Ruud M
Publication year - 2014
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12196
Subject(s) - melatonin , placebo , bipolar disorder , blood pressure , endocrinology , medicine , metabolic syndrome , schizophrenia (object oriented programming) , adverse effect , psychology , psychiatry , obesity , pathology , alternative medicine , lithium (medication)
Objective Second‐generation antipsychotics ( SGA s) are among the first‐line treatments for bipolar disorder and schizophrenia, but have a tendency to generate metabolic disturbances. These features resemble a metabolic syndrome for which a central autonomic imbalance has been proposed that may originate from the hypothalamic suprachiasmatic nuclei. In a clinical trial, we hypothesized that melatonin, a hormone that regulates the suprachiasmatic nucleus, could attenuate SGA‐induced adverse metabolic effects. Methods In an eight‐week, double‐blind, randomized, placebo‐controlled, parallel‐group clinical trial, we evaluated the metabolic effect of melatonin in SGA ‐treated patients in terms of weight, blood pressure, lipid, glucose, body composition, and anthropometric measures. A total of 44 patients treated with SGA s, 20 with bipolar disorder and 24 with schizophrenia, randomly received placebo (n = 24) or melatonin 5 mg (n = 20). Results The melatonin group showed a decrease in diastolic blood pressure (5.1 versus 1.1 mmHg for placebo, p = 0.003) and attenuated weight gain (1.5 versus 2.2 kg for placebo, F = 4.512, p = 0.040) compared to the placebo group. The strong beneficial metabolic effects of melatonin in comparison to placebo on fat mass (0.2 versus 2.7 kg, respectively, p = 0.032) and diastolic blood pressure (5.7 versus 5.5 mmHg, respectively, p = 0.001) were observed in the bipolar disorder and not in the schizophrenia group. No adverse events were reported. Conclusions Our results show that melatonin is effective in attenuating SGA s' adverse metabolic effects, particularly in bipolar disorder. The clinical findings allow us to propose that SGAs may disturb a centrally mediated metabolic balance that causes adverse metabolic effects and that nightly administration of melatonin helps to restore. Melatonin could become a safe and cost‐effective therapeutic option to attenuate or prevent SGA metabolic effects.