A comparative study of the effects of prostaglandins and d-amphetamine on the metabolism of 3H-dopamine continuously presented to rat brain in vivo

Niacin subsensitivity is associated with functional impairment in schizophrenia

OBJECTIVE

Sensitivity to the skin flush effect of niacin is reduced in a portion of patients with schizophrenia. Though this peripheral physiological abnormality has been widely replicated, its relevance to neuropsychiatric manifestations of the illness has been unclear. The goal of this study was to determine if the niacin response abnormality in schizophrenia is associated with functional impairment.

METHODS

Following psychiatric assessment, a Global Assessment of Functioning (GAF) score was assigned to each of 40 volunteers with schizophrenia. For each subject, the blood flow responses to several concentrations of topical methylnicotinate were recorded. Blood flow was measured objectively, using laser Doppler flowmetry. From the dose-response data, EC(50) values were derived. GAF scores were assigned without knowledge of the participants' niacin response data.

RESULTS

There was a significant negative correlation between GAF scores and EC(50) values for methylnicotinate (Pearson r=-0.42; p=0.007).

CONCLUSIONS

Reduced niacin sensitivity is associated with greater functional impairment among patients with schizophrenia. These findings raise the possibility that a subset of schizophrenia patients possesses a biochemical abnormality that reduces niacin sensitivity in the skin and contributes to functional impairment from the disease.

Relationship between the niacin skin flush response and essential fatty acids in schizophrenia

The skin flush response to niacin is selectively mediated by the release of vasodilatory prostaglandins from the skin. The normal skin flush response to niacin is attenuated in many individuals with schizophrenia (SCZ). This finding suggests abnormal prostaglandin signaling in SCZ. Since prostaglandins are derived from arachidonic acid (AA), the finding of an abnormal skin flush response is consistent with biochemical data suggesting relative depletion of AA, and other essential fatty acids (EFAs), in a substantial portion of people with SCZ. This paper will describe the mechanism of the skin flush response to niacin, and will review evidence that the response to niacin is abnormal in SCZ, that this abnormality is not related to psychotropic medications, and that it may be a marker of the EFA deficiency which has been documented to be present in many patients with SCZ.

The relationship between schizophrenia and essential fatty acid and eicosanoid metabolism

Essential fatty acids (EFAs) and their eicosanoid derivatives are important constituents of the brain and regulators of neuronal function. There is direct and indirect evidence of impaired metabolism of prostaglandin (PG)E1 in schizophrenia. There is also direct evidence of abnormal EFA biochemistry with plasma phospholipids from five populations and brain phospholipids from another all showing reduced levels of linoleic acid and elevated levels of 22-carbon EFAs of both n-6 and n-3 series. Clinical trials of PGE1 and of the PGE1 precursors, gamma-linolenic acid (GLA) and dihomo-gamma-linolenic acid (DGLA) have shown modest therapeutic effects. In view of lack of therapeutic process involving drugs based on the dopamine concept of schizophrenia, it is time for new approaches based on the EFA/PG concept to be evaluated thoroughly.

Effects of indomethacin on plasma homovanillic acid concentration in normal subjects: a study of prostaglandin-dopamine interactions

In laboratory animals, prostaglandins have been shown to act as endogenous neuromodulators of central dopamine (DA) activity. To examine the interaction between prostaglandins and DA in man, the effect of a prostaglandin synthesis inhibitor, indomethacin, was studied on plasma concentrations of the DA metabolite, homovanillic acid (pHVA). Indomethacin (150 mg PO) as compared to placebo significantly elevated mean pHVA concentrations in eight normal subjects. Results of this study support the hypothesis that, as in animals, inhibition of prostaglandin synthesis increases central DA turnover in man.

A double-blind trial of essential fatty acid supplementation in patients with tardive dyskinesia

This study reports the results of a trial of essential fatty acid (EFA) supplementation in psychiatric patients (predominantly schizophrenics) with movement disorders. Evidence of EFA deficiency in these patients was observed. The antidyskinetic effect of EFA supplementation was marginally significant but not clinically important. However, active treatment produced highly significant improvements in total psychopathology scores and schizophrenia subscale scores, and a significant improvement in memory.

Neural mechanisms mediating the hyperthermia elicited by prostaglandin E2 injected into the preoptic-anterior hypothalamus

The neuromechanism mediating the hyperthermia induced by injection of PGE2 into the preoptic/anterior hypothalamus (PO/AH) was investigated in the rat. Pretreatment of rats with intraperitoneal injection of atropine sulfate blocked, whereas pretreatment with atropine methyl bromide had no significant effect on the hyperthermia. In a second series of experiments, atropine sulfate was microinjected into different regions of the hypothalamus and the thalamus in an attempt to locate the central cholinergic synapses involved in the PGE2-induced hyperthermia. The hyperthermia was blocked by atropine injection into the dorsal/dorsomedial hypothalamic area (DH), but was not significantly affected by injection into the PO/AH, ventromedial hypothalamus, or the thalamic area above the DH. Moreover, microinjection of the cholinergic agonist carbachol (0.5 microgram) into the DH could also elicit hyperthermia. Thus, our data suggest that the hyperthermia induced by PGE2 administration into the PO/AH is mediated by a cholinergic mechanism in the DH.

d-Amphetamine antagonizes prostaglandin E1-induced hyperthermia and suppression of fixed interval operant behavior in rats

The experiments reported herein were designed to study the effects of prostaglandin F2 alpha (PGF2 alpha) and PGE1 on operant behavior and rectal temperature of rats. A solution containing PGF2 alpha or PGE1 was infused intracerebroventricularly into rats trained to press a lever for food reward on a fixed interval 75 second (FI 75 sec) schedule. PGF2 alpha (10, 100 or 1000 ng/min) had no effect on FI 75 sec operant behavior. Only the highest dose increased temperature. PGE1 (100 ng/min) had no effect, whereas higher doses (250 and 500 ng/min) produced a rate-dependent effect on behavior, increasing low rates and decreasing high rates. The two higher doses also produced convulsions after about 25 min or 20 min infusions, respectively. PGE1 also increased temperature in a dose-dependent manner. Systemic administration of a low dose of d-amphetamine (0.5 mg/kg IP) had little or no effect on behavior or temperature. d-Amphetamine did not alter hyperthermia induced by the highest dose of PGF2 alpha, but antagonized the PGE1-induced hyperthermia. d-Amphetamine also antagonized all of the behavioral effects of PGE1, including convulsions. The results are discussed in relation to the actions of PGs and d-amphetamine on catecholamine neurons in the central nervous system.

Indomethacin potentiates the operant behavior suppressant and rectal temperature lowering effects of low doses of d-amphetamine in rats

Prostaglandins (PGs) may be important in modulating the actions of d-amphetamine. To test this hypothesis male rats were pretreated with indomethacin to inhibit PG synthesis before d-amphetamine was injected. Indomethacin (5 mg/kg, IP) was found to be without direct effect upon fixed-ratio behavior or rectal temperature, but significantly enhanced the capacity of low doses of d-amphetamine to suppress behavior and lower temperature. These effects were not due to partial food deprivation or to an increase in the concentration of d-amphetamine in brain. It is concluded that one or more of the PGs modulate the central actions of d-amphetamine, perhaps by modifying the release and/or reuptake of catecholamines, or through a postsynaptic action.