IMMUNOMODULATORY
EFFECTS OF PSYCHOTROPIC DRUGS
*D.
Hinze-Selch, E.W. Becker, G. Stein, a. Schuld, T. Kraus, M.
Haack, and T. Pollmächer. Max-Planck-Institute of Psychiatry,
Munich, Germany
Malaria/fever therapy in the
beginning of this century gives early evidence for a link between
the immune system and psychiatric disorders. Chlorpromazine, the
first neuroleptic agent in clinical use, has antiparasitic and in
vitro immunomodulatory effects. Various in vitro and in vivo
peculiarities of the immune system have been described in
psychiatric disorders such as major depression and schizophrenia.
However, immunomodulatory properties of psychoactive drugs have
neither been investigated systematically nor considered
systematically in studies on the immune system of psychiatric
patients.
Therefore, we have been analyzing
in vivo and in vitro effects of psychoactive drugs on the immune
system of psychiatric patients and we have tried to link such
immunomodulatory effects to psychotrophic effects.
We found that the atypical
neuroleptic agent clozapine increases plasma levels of the
cytokines and soluble cytokine receptors TNF-a ,
sTNFRp55, sTNFRp75 and sIL-2r while in vitro immune variables
were affected in a complex way in the course of a 6 week
treatment with clozapine in schizophrenic patients1,2.
The class neuroleptic haloperidol does not have such effects3.
Whereas clozapine in patients and a non-pyrogenic dose of
endotoxin in healthy probands both increase stage 2 sleep the
immunologically non-active compound haloperidol increases stage 1
sleep4. However, the immunodulatory property is not
restricted to clozapine because the antidepressants ami-triptylin
and nortriptylin also increase plasma levels of both soluble
TNF-receptors in patients.
We conclude that some
psychoactive drugs have immunomodulatory effects whereas others
have not and that this property is independent of the
psychopharmacological characterization of the substances as
neuroleptics or antidepressants. As demonstrated for
polysomnographic nightsleep, a function regulated by the CNS,
such immunomodulation might even be involved in psychotrophic
effects. Therefore, we hypothesise that immunomodulation is a
considerable characteristic of a subgroup of psychoactive
substances and even predicts some psychoactive properties.
1 Pollmächer et al.
J. Clin Psychopharmacol 1996, 16:403-409
2Hinze-Selch et al.
Neuropsychpharmacology 1998, 19:114-122
3 Pollmächer et al.
Am J Psychiatry 1997, 154:1763-1765
4Hinze-Selch et al.
Biol Psychiatry 1997, 42:260-266