Psychiatry - December 2008 - (Page 51)

Update on Blood Brain Barrier of this hypothesis is to explore the complicated interactions between neurotransmission, calcium signalling, and thermoregulation resulting from a challenged BBB in the hypothalamic region of the brain. KEY WORDS blood brain barrier, calcium signalling, thermoregulation, neurotransmission INTRODUCTION Psychiatric symptoms often can only be described subjectively unless presenting with somatization and, if not managed effectively, may have devastating outcomes. Effective management of psychiatric disorders frequently involves titration or tapering, adding, or switching psychotropic medications. Presently, there are no clinically reliable physical signs, biochemical markers, or technological tools to accurately determine the response to treatment. Adverse reactions or drug side effects, therefore, pose a threat and, in some cases, are lethal. Neuroleptic malignant syndrome (NMS) is one of the most devastating of such adverse reactions, raising the body temperature above 40˚C. Hypothermia, on the other hand, is rare with no designated term like NMS. Both hyper- and hypothermia seem to result from variations in neurotransmitter levels commonly seen not only in neuropsychiatry secondary to the use of psychotropics but also in pain management involving anesthetics. Interestingly, the link between thermoregulation and neurotransmission is largely dependent on intracellular calcium homeostasis. The goal of this hypothesis is to connect the complicated yet interdependent 12, DECEMBER] THERMOREGULATION AND THE ROLE OF CALCIUM SIGNALLING IN NEUROTRANSMISSION by Atmaram Yarlagadda, MD, and Anita H. Clayton, MD Psychiatry (Edgemont) 2008;5(12):51–54 ABSTRACT Understanding the functional capacity of the human brain at a molecular level continues to be a challenge despite modern scientific and technological advances. Extreme variations in thermoregulation, whether induced by genetic predisposition or changes in internal, external or central factors, appear to be caused by altered calcium signalling at the neurotransmitter level and are likely due to a compromised blood brain barrier (BBB) in the hypothalamic region. The objective [VOLUME 5, NUMBER Psychiatry 2008 51

Table of Contents Feed for the Digital Edition of Psychiatry - December 2008

Psychiatry - December 2008 Editor’s Message Contents Editorial Advisory Board Antidepressant Prescribing by Specialty and Treatment of Premenstrual Dysmorphic Disorder Pain, Pain, Go Away: Antidepressants and Pain Management Why Psychotherapy Helps the Patient in Chronic Pain General Medical Drugs Associated with Depression Katatonia: A New Conceptual Understanding of Catatonia and a New Rating Scale Thermoregulation and the Role of Calcium Signalling in Neurotransmission Cognition and Schizophrenia: Is There a Role for Cognitive Assessments in Diagnosis and Treatment? Journal Watch Information for Authors

Psychiatry - December 2008

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