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Is Quetiapine the most potent anti-cortisol drug out there?

quetiapine cortisol acth muscarinic acetylcholine norquetiapine depression anxiety

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#1 agwoodliffe

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Posted 25 July 2016 - 09:26 PM


This is besides the use of medications which are used to treat the serious condition Cushing's Disease.

 

Quetiapine has been shown in 1 study to greatly dampen the release of ACTH and Cortisol levels in healthy subjects, outperforming a comparable drug Olanzapine.

https://www.deepdyve...iapine+cortisol

Another study found that 1 patient actually developed hypocortisolism whilst taking the drug.

http://www.ncbi.nlm....pubmed/23757611

 

What interests me is why this is. Quetiapine has been shown to act as an antagonist at 5-HT2, alpha1 and H1 receptors, all of which have a positive effect on cortisol release.

However, I suspect that its metabolite, Norquetiapine, also has a part to play.

 

Norquetiapine, unlike its parent, is an antagonist at several muscarinic receptors (although nowhere near as powerful as Olanzapine and Clozapine). And I just read on google books ''Neuroendocrinology Of Mood'', by D. Ganten and D. Pfaff, that signalling through muscarinic receptors has a positive influence on the HPA axis. For instance ''physostigmine and arecoline [cholinomimetics] infusions significantly increase serum ACTH and cortisol levels in normals and psychiatric patients''.

Although other literature suggests that nicotinic receptors are more involved in this than muscarinic receptors per se, I must add that the text also says ''it appears that physostigmine-induced elevations in serum ACTH, cortisol and B-endorphin are due to a central muscarinic mechanism, since such increases are blocked by the centrally acting antimuscarinic agent scopolamine''.

[[please refer to page 219]]

 

So I'd like to ask you guys, have you ever felt more distressed or 'depressed' whilst on cholinergic drugs?


Edited by agwoodliffe, 25 July 2016 - 09:50 PM.






Also tagged with one or more of these keywords: quetiapine, cortisol, acth, muscarinic, acetylcholine, norquetiapine, depression, anxiety

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