Study Finds Second Generation Antipsychotics (SGAs) Activates MC4R Gene Trigerring Obesity and Weight Gain

Second Generation Antipsychotics (SGAs) are antipsychotic medication used to treat psychotic conditions such as schizophrenia. Other conditions that are FDA approved for SGAs are acute mania, bipolar depression, psychotic agitation, and bipolar maintenance.

Also known as Atypical Antipsychotics (AAP), these class of drugs differ from First Generation Antipsychotics (FGAs) in that they are less likely to cause extrapyramidal motor control disabilities in patients, which include unsteady Parkinson's disease-type movements, body rigidity and involuntary tremors. These abnormal body movements can become permanent even after medication is stopped.

Atypical Antipsychotics are said to be safer than typical antipsychotics (FGAs) because of

• Higher rate of responders
• Efficiency in patients with refractory disease
• Lower risk of suicides and depression
• Better functional capacity
• Improved Quality of Life

Second Generation Antipsychotics (SGAs)

Both FGAs and SGAs function the same way by blocking receptors in the dopamine pathways in the brain. There is still ongoing debate whether SGAs are a better treatment than FGAs.

Despite the benefits of SGAs, there are still side effects when taking the medication such as tardive dyskinesia (a serious movement disorder), neuroleptic malignant syndrome, and increased risk of stroke, sudden cardiac death, blood clots, and diabetes.

One significant side effect that is identified with SGA is obesity and rapid and significant weight gain.

Researchers discover gene that leads to severe weight gain with antipsychotic treatment

Antipsychotic medications are increasingly prescribed in the US, but they can cause serious side effects including rapid weight gain, especially in children. In the first study of its kind, researchers at Zucker Hillside Hospital and the Feinstein Institute for Medical Research identified a gene that increases weight gain in those treated with commonly-used antipsychotic drugs. These findings were published in the May issue of Archives of General Psychiatry.

Second-generation antipsychotics (SGAs) were used as the treatment in this study. SGAs are commonly used to treat many psychotic and nonpsychotic disorders. However, it is important to note that these SGAs are associated with substantial weight gain, including the development of obesity and other cardiovascular risk factors. The weight gain side effect of SGAs is significant because it often results in a reduced life expectancy of up to 30 years in those who suffer from chronic and severe mental illnesses. The weight gain also prompts some to stop taking the medication, adversely impacting their quality of life.

Cognitive Behavioral Therapy (CBT) As An Effective Prevention in the Development of Psychotic Symptoms And Schizophrenia

Cognitive behavioural therapy (CBT) is psychological therapy that helps manage a patient's problems by changing how he or she thinks and acts. It is a psychotherapeutic approach commonly called a talking therapy.

CBT aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure dwelling in the present situation rather than looking back at the past. The title is used in diverse ways to designate behavior therapy, cognitive therapy, and to refer to therapy based upon a combination of basic behavioral and cognitive research.

With CBT, the patient is encouraged to talk about his feelings and his thoughts. Topics such as how he views himself, the world and other people; how it affects his thoughs and feelings are discussed. By discussing these things, CBT helps change how the patient thinks and does which helps him or her in feeling better about life and his situation.

Cognitive Behavioral Therapy is used in psychological problems such as anxiety, depression, post-traumatic stress disorder, eating disorders and drug misuse. It has been proven to be helpful in these situations as CBT focuses on the problems and difficulties the patient has at the present rather than issues dealt with in the past.

It looks for practical ways in which to improve the state of mind on a daily basis.

Cognitive therapy helps reduce severity of distress among psychotic patients

Cognitive therapy reduces the severity of psychotic experiences in adults who are at risk of developing conditions such as schizophrenia, a randomised controlled trial published on bmj.com claims.

Authors from several UK universities (Birmingham, Glasgow, Cambridge, Manchester and UEA), led by the University of Manchester, set out to determine whether cognitive therapy, combined with monitoring, is effective in preventing the development and worsening of psychotic symptoms which can lead to schizophrenia, in young adults who were actively seeking help and were considered at high risk of developing schizophrenia and similar serious mental disorders. Risk factors included having intermittent or very mild symptoms suggesting psychosis, or schizophrenia-like personality problems, or having at least one close relative with psychosis. Monitoring was defined as aiming to provide warm, emphatic and supportive face-to-face contact.

New Insights Into Psychopathy

Psychological research suggests that psychopathy is a personality disorder that is widely misunderstood. Pyscopaths are typically depicted as charming, intriguing, dishonest, guiltless, and in some cases, downright terrifying.

Jennifer Skeem, Professor of Psychology and Social Behavior at the University of California, Irvine, Devon Polaschek of Victoria University of Wellington, Christopher Patrick of Florida State University, and Scott Lilienfeld of Emory University are the authors of a new monograph focused on understanding the psychopathic personality that will appear in the December issue of Psychological Science in the Public Interest, a journal of the Association for Psychological Science.

“Psychopathy tends to be used as a label for people we do not like, cannot understand, or construe as evil,” Skeem notes. “Psychopathy has long been assumed to be a single personality disorder. However, there is increasing evidence that it is a confluence of several different personality traits,”

They note that many scientific findings seemed to contradict one another.

Video: What is a psycopath: a classic explanation

Skeem, Patrick and Lilienfeld argue that psycopathy is a complex, multifaceted condition marked by blends of personality traits reflecting differing levels of disinhibition, boldness, and meanness rather than being "one thing" as often assumed. And scientific findings also suggest that a sizable subgroup of juvenile and adult offenders labeled as psychopathic are actually more emotionally disturbed than emotionally detached, showing signs of anxiety and dysphoria.

According to Skeem, these important distinctions have long escaped the attention of psychologists and policy-makers. They have set about to try and dispel some of the public myths and assumptions about psychopathy:

• Psychopaths are born, and not made: The authors stress that psychopathy is not just a matter of genes, it may have multiple constitutional causes that can be shaped by environmental factors. 
• Once a psychopath, always a psychopath: However, there is currently scant scientific evidence to support this claim. Recent empirical work suggests that youth and adults with high scores on measures of psychopathy can show reduced violent and other criminal behavior after intensive treatment.

Along with challenging the assumption that psychopathy is a monolithic entity, perhaps the other most important myth that the authors hope to dispel is that psychopathy is synonymous with violence. Skeem points out that psychopathic individuals often have no history of violent behaviour or criminal convictions. “Psychopathy cannot be equated with extreme violence or serial killing. In fact, “psychopaths” do not appear different in kind from other people, or inalterably dangerous,” she observes. Nor is it clear that psychopathy predicts violence much better than a past history of violent and other criminal behavior – or general antisocial traits.

Effectively dispelling these myths is important, the authors argue, because accurate policy recommendations hinge on which personality traits – and which groups of people – associated with psychopathy one is examining. “Decisions about juvenile and adult offenders that are based on faulty assumptions about violence risk, etiology, and treatment amenability have adverse consequences, both for individual offenders and the public,” Skeem says.

In clarifying the personality traits that characterize psychopathy, scientists can contribute to prevention and treatment strategies that improve public health and safety. “In short, research on psychopathy has evolved to a level that it can greatly improve on the current, ‘one size fits all’ policy approach,” concludes Skeem.

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