Cerebral cortical gray expansion associated with two second-generation antipsychotics.
BACKGROUND
Second-generation antipsychotics (SGAs) differ from first-generation antipsychotics (FGAs) with respect to induction of less extrapyramidal morbidity, partially reducing negative symptoms, and causing modest improvement in neurocognitive functioning in patients with schizophrenia. SGAs demonstrate 5-HT2a antagonism. Differential effects of SGAs and FGAs on cortical gray volumes are explored herein.


METHODS
Cerebral cortical gray was examined volumetrically in 19 patients with schizophrenia before and following 28 days of treatment with two SGAs (risperidone and ziprasidone; n = 13) or a FGA (haloperidol; n = 6). Seven (untreated) control subjects were also assessed at a similar interval.


RESULTS
During treatment with the SGAs risperidone and ziprasidone, cerebral cortical gray of 13 patients with schizophrenia expanded 20.6 +/- 11.4 cc (p < .0005). Six patients receiving the FGA haloperidol, as well as 7 control subjects, showed no change in cortical gray volumes (p = .983 and p = .932, respectively) at the time of reassessment.


CONCLUSIONS
Volumetric increase of cerebral cortical gray occurred early in the course of treatment with the SGAs ziprasidone and risperidone, but not with the FGA haloperidol. Such cortical gray expansion may be relevant to the reported enhanced neurocognition and quality of life associated with SGA treatment.
Department of Psychiatry and Behavioral Science, University of Louisville School of Medicine, Louisville, Kentucky, USA. david.garver@insightbb.com
David L
DL
Garver
Jennifer A
JA
Holcomb
James D
JD
Christensen
D000328:Adult; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001284:Atrophy / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D002540:Cerebral Cortex / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D003072:Cognition Disorders / Q000378:metabolism / Q000473:pathology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006220:Haloperidol / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009414:Nerve Growth Factors / Q000378:metabolism; D010879:Piperazines / Q000009:adverse effects* / Q000494:pharmacology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D018967:Risperidone / Q000009:adverse effects* / Q000494:pharmacology; D012559:Schizophrenia / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D012565:Schizophrenic Psychology; D013844:Thiazoles / Q000009:adverse effects* / Q000494:pharmacology; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D009414:Nerve Growth Factors; D010879:Piperazines; D013844:Thiazoles; C092292:ziprasidone; D006220:Haloperidol; D018967:Risperidone