Researchers Find Ways to Limit Metabolic Side Effects of Antipsychotic Drugs

By Amie Dahnke

Antipsychotic medications can disrupt metabolism, increasing a person’s risk of developing diabetes. However, researchers have found a way to prevent such development, according to a study published Thursday.

The study, published in Diabetes, shows early evidence that new treatments could limit the side effects of antipsychotics by blocking their activity in the pancreas.

“Antipsychotic medications don’t just stop working below the neck,” Dr. Zachary Freyberg, associate professor of psychiatry and cell biology at the University of Pittsburgh and senior author of the study, said in a news release. They work by blocking dopamine receptors in the brain, restricting the flow of dopamine, and thereby controlling psychotic symptoms.

However, the researchers showed that the same dopamine receptors are also in the pancreas. Antipsychotic drugs can, therefore, interfere with these receptors in the pancreas.

Since the pancreas is responsible for blood sugar regulation, such disruptions can cause high blood sugar and insulin levels and prediabetes, which increase a person’s risk of diabetes.

Therefore, the researchers found that stimulating these dopamine receptors in the pancreas could limit certain side effects of antipsychotic drugs, including impaired control of blood sugar.

Blocking Metabolic Disruptions in the Pancreas

Dr. Freyberg and his team created a molecule called bromocriptine methiodide (BrMeI) alongside researchers at the National Institutes of Health’s National Institute on Drug Abuse. BrMeI can activate dopamine receptors in the pancreas, thereby preventing antipsychotics from disrupting pancreatic activity.

BrMeI is similar to bromocriptine, a drug approved by the U.S. Food and Drug Administration (FDA) to treat Type 2 diabetes. One difference? BrMeI was modified so it is less likely to pass through the brain-blood barrier, limiting its activity to the body and not the brain.

Early trials in mice show that BrMel can prevent antipsychotic medications from affecting organs, such as the pancreas. When taken with the antipsychotic drug, it can reverse or prevent dysglycemia.

In an interview with The Epoch Times, Dr. Freyberg said, “BrMeI on its own did not significantly diminish elevations in glucose. However, when BrMeI is administered alongside antipsychotic medications, this combination of drugs may help prevent the metabolic actions of antipsychotic actions outside of the brain, which would represent a positive therapeutic benefit.

“Next-generation antipsychotic drugs can be modified as a new strategy to control dysglycemia and diabetes,” he added.

Dr. Freyberg said the key is to ensure the antipsychotic medication’s effects work in conjunction with BrMeI. He and his team hope to test this theory in a future clinical trial, observing the efficacy of BrMeI and similar molecules over the next several years.

“The fact that both the brain and the body are required to maintain stable glycemic control provides a novel dimension in understanding neuropsychiatry and begins to integrate disparate pieces of knowledge about different organ systems into a coherent whole,” Dr. Freyberg said.

In the meantime, Dr. Freyberg noted that physicians should work with and monitor their patients while they take these medications.

“The majority of psychiatric medications are prescribed by general practitioners and not psychiatrists,” he added. “We hope that our research builds awareness about the importance of communication between the brain and the rest of the body in maintaining physiological functions and reminds clinicians that they should also consider that drugs designed to act on targets in the brain, like psychiatric medications, may also have significant actions outside of the brain when making prescription recommendations.”