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Effect of Acute Metabolic Stress on Pituitary-Adrenal Axis Activation in Patients With Schizophrenia

OBJECTIVE: Although several lines of evidence suggest that stress plays a role in the course of schizophrenia, studies that have assessed stress-relevant neurobiological measures have not produced consistent results. The authors examined the effects of acute metabolic stress induced by 2-deoxy-D-glucose (2-DG) on pituitary-adrenal axis activation. METHOD: Thirteen patients with schizophrenia and 11 healthy comparison subjects were administered pharmacological doses of 2-DG (40 mg/kg). The subjects' arterial plasma was then assayed for levels of adrenocorticotropic hormone (ACTH) and cortisol. RESULTS: 2-DG induced significant increases in the measured hormones in both groups, and ACTH elevations were significantly greater in patients with schizophrenia than in comparison subjects. CONCLUSIONS: Patients with schizophrenia have an exaggerated ACTH response to acute metabolic stress exposure. (Am J Psychiatry 1998; 155:979–981)

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