FDG-PET in never-previously medicated psychotic adolescents treated with olanzapine or haloperidol.
We acquired Positron emission tomography with 18-F-deoxyglucose (FDG-PET) and anatomical MRI in 30 never-previously medicated psychotic adolescents (ages 13-20). (FDG-PET) was obtained at baseline and after 8-9 weeks of a randomized double-blind trial of either olanzapine or haloperidol. Neuropsychological tests of executive function were also obtained. Patients carried out the serial verbal learning task, a modification of the California Verbal Learning Test, during the uptake of the FDG. PET scans were coregistered with spoiled gradient MRI (TR=24, TE=5, flip angle 40 degrees, slice thickness 1.2 mm, field of view 230 mm) for accurate anatomical identification of regions of interest traced on the MRI. Twenty-two of the thirty patients completed the second PET and clinical evaluation. Individuals treated with olanzapine increased relative metabolic rates in the frontal lobe more than the occipital lobe while patients treated with haloperidol failed to increase frontal metabolic rates and did not show an anteroposterior gradient in medication response. Haloperidol increased striatal metabolic rate more than olanzapine. Both drugs increased thalamic metabolic rates and this increase was significantly larger in younger (age 13-15) than older (16-21) patients.
Buchsbaum
Monte S
MS
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA. Monte.buchsbaum@gmail.com
Haznedar
M Mehmet
MM
Aronowitz
Jonathan
J
Brickman
Adam M
AM
Newmark
Randall E
RE
Bloom
Rachel
R
Brand
Jesse
J
Goldstein
Kim E
KE
Heath
Desmond
D
Starson
Meghan
M
Hazlett
Erin A
EA
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D001921:Brain / Q000033:anatomy & histology / Q000187:drug effects / Q000378:metabolism*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005625:Frontal Lobe / Q000033:anatomy & histology / Q000187:drug effects / Q000378:metabolism; D006220:Haloperidol / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D009778:Occipital Lobe / Q000033:anatomy & histology / Q000187:drug effects / Q000378:metabolism; D000077152:Olanzapine; D049268:Positron-Emission Tomography; D011618:Psychotic Disorders / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000453:epidemiology; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D013702:Temporal Lobe / Q000033:anatomy & histology / Q000187:drug effects / Q000378:metabolism
D014150:Antipsychotic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D001569:Benzodiazepines; D006220:Haloperidol; D000077152:Olanzapine