psikiyatrik bozukluklard obezite psikiyatrik bozukluklard obezite ...

Cortex & limbic system
‘Reward’
Dopamine, Opioids and
Endocannabinoids
APD
+
Arcuate
nucleus
+
Orexin NPY AGRP
+
+
5HT 2c R Leptin R
+
Paraventricular
nucleus
Insulin
+
–
APD?
+
Hypothalamus
APD
Food Intake
POMC αMSH
CART
Model of regulation of food intake. Appetite is stimulated by neurones containing neuropeptide Y (NPY) and agouti agouti­
related protein (AGRP) in the lateral hypothalamic area. Food intake is inhibited by α­melanocyte­stimulating
hormone (αMSH) and cocaine­ and amphetamine­regulated regulated transcript peptide (CART). Regulation of this final
pathway is affected by signals from the gut, adipose tissue and reward system. The potential places where
antipsychotics interact with this system are shown by the term APD (antipsychotic drugs). The precise effects of
antipsychotics on gastrointestinal signals and leptin remain to be determined. 5HT 2c , 5­hydroxytryptamine 2c , POMC,
pro­opiomelanocortin; PPY, peptide YY 3­36 . Diabetes, Obesity and Metabolism, 11, 2009, 665 665–679
–
–
Leptin
+
+
APD?
–
+/–
Leptin R H 1 R
MC­4 receptor
CART receptor
Ghrelin
PPY
Vagus nerve
+/–
Lateral hypothalamus