Pharmacopsychiatry 2008; 41(3): 115-116
DOI: 10.1055/s-2008-1058110
Letter

© Georg Thieme Verlag KG Stuttgart · New York

Improvement of General Symptoms in a Chronic Psychotic Patient Treated with Finasteride: Case Report

D. Koethe 1 , M. Bortolato 2 , D. Piomelli 3 , F. M. Leweke 1
  • 1Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
  • 2Department of Neuroscience “Bernard B. Brodie”, University of Cagliari, Cagliari, Italy
  • 3Departments of Pharmacology and Biological Chemistry, University of California, Irvine, Irvine, CA, USA and Unit of Drug Discovery and Development, Italian Institute of Technology, Genoa, Italy
Further Information

Publication History

received 01.10.2007 revised 19.12.2007

accepted 02.01.2008

Publication Date:
19 May 2008 (online)

Introduction

Recent evidence indicates that neuroactive steroids (NS) may participate in the pathogenesis of the schizophrenia spectrum of disorders. NS levels have been correlated to symptom severity in schizophrenic patients [8], and have been shown to influence the function of major key substrates involved in the pathophysiology of psychotic disorders, such as the dopaminergic mesolimbic system [3] [5]. Bortolato et al. [1] investigated the role of 5α-reductase (5AR), the rate-limiting enzyme of one of the two major metabolic pathways in brain steroidogenesis, in schizophrenia, suggesting that 5AR inhibitors elicit antipsychotic-like effects in animals.

5AR converts ketosteroid precursors (such as prostagens, androgens and glucocorticoids) into their active 5α-reduced metabolites. Two isoforms of 5AR have been identified so far, differing in chemical characteristics and tissue distribution.

References

  • 1 Bortolato M, Frau R, Orru M. et al . Antipsychotic-like properties of 5-α-reductase inhibitors.  Neuropsychopharmacology. 2007;  in press
  • 2 Cabrera RJ, Bregonzio C, Laconi M, Mampel A. Allopregnanolone increase in striatal N-methyl-D-aspartic acid evoked [3 H]dopamine release is estrogen and progesterone dependent.  Cell Mol Neurobiol. 2002;  22 445-454
  • 3 Carlsson A. The neurochemical circuitry of schizophrenia.  Pharmacopsychiatry. 2006;  39 ((Suppl 1)) S10-14
  • 4 Hernandez L, Gonzalez L, Murzi E. et al . Testosterone modulates mesolimbic dopaminergic activity in male rats.  Neurosci Lett. 1994;  171 172-174
  • 5 Khisti RT, Deshpande LS, Chopde CT. The neurosteroid 3 alpha-hydroxy-5 alpha-pregnan-20-one affects dopamine-mediated behavior in rodents.  Psychopharmacology (Berl). 2002;  161 120-128
  • 6 Leucht S, Kissling W, Busch R. Early prediction of non-response – when should antipsychotic drugs be switched?.  Pharmacopsychiatry. 2007;  40 205-255
  • 7 Petitclerc M, Bedard PJ, Di Paolo T. Progesterone releases dopamine in male and female rat striatum: a behavioral and microdialysis study.  Prog Neuropsychopharmacol Biol Psychiatry. 1995;  19 491-497
  • 8 Ritsner M, Maayan R, Gibel A, Weizman A. Differences in blood pregnenolone and dehydroepiandrosterone levels between schizophrenia patients and healthy subjects.  Eur Neuropsychopharmacol. 2007;  17 358-365
  • 9 Ugale RR, Hirani K, Morelli M, Chopde CT. Role of neuroactive steroid allopregnanolone in antipsychotic-like action of olanzapine in rodents.  Neuropsychopharmacology. 2004;  29 1597-1609

Notice:

This article was changed according to the following erratum on June 22nd 2011.

Erratum:

The correct affiliations of D. Piomelli are:

Departments of Pharmacology and Biological Chemistry, University of California, Irvine, Irvine, CA, USA and Unit of Drug Discovery and Development, Italian Institute of Technology, Genoa, Italy

Correspondence

D. KoetheMD 

Department of Psychiatry and Psychotherapy

University of Cologne

Kerpener Str. 62

50924 Cologne

Germany

Phone: +49/221/478 86 231

Fax: +49/221/478 87 200

Email: koethe@ecnp.net