The administration of both typical and atypical anti-psychotic medication is associated with the metabolic side-effects that include weight gain and diabetes mellitus, with atypical anti-psychotics (APPs) conferring the greatest risk.1
AAPs gained much popularity when first introduced due to their extensive spectrum of efficacy and their low risk of extrapyramidal symptoms in comparison to typical anti-psychotic drugs.2 They have become the first line of treatment for psychotic disorders however, unlike their counterparts, AAPs have been associated with a greater risk for metabolic side effects.3
These side effects also present as risk factors for cardiovascular diseases, insulin resistance and other metabolic disorders.4 A further…show more content… Leptin is an adipose-released hormone that works on the hypothalamus to control appetite and peripheral regulation of energy metabolism. Leptin works to inhibit the effects of appetite-stimulating hormones while stimulating the effects of hormones such as corticotrophin-releasing factor that suppress appetite stimulations. 5
Sensory pathways bringing in information from the blood and CSF to the hypothalamus, have their first order neurons in the ARC. It contains the neuropeptide Y (NPY)/agouti-related protein (AgRP) neurons and the pro-opiomelanocortin (POMC)/cocaine- and amphetamine- related transcript (CART) neurons which play a role in the simulation of food intake. 6
Serotonin signaling in the central nervous system produces hyophagia through its effects on the suppression of food intake. The anorexigenic 5HT2C receptor is largely expressed in the hypothalamus, particularly in the POMC neurons of the arcuate nucleus where stimulation of PMOC neural activity via this receptor results in hypophagia and weight loss. 7 5HT is a potent satiety signaler with 5-HT1A and 5-HT2C receptors as the prime mediators of 5HT in regulating food intake. The action of serotonin on these receptors confers opposing results. Binding of serotonin on 5-HT1A increases food intake while 5HT2C decreases it.
Serotonin when produced in the CNS acts as a neurotransmitter, however a large proportion of serotonin