Effect of risperidone versus haloperidol on emotional responding in schizophrenic patients.
BACKGROUND
Studies on emotional processing report that schizophrenic patients present a specific pattern of emotional responding that usually includes deficits in emotional expressiveness, increased feelings of unpleasant emotion but decreased feelings of pleasant emotion, and increased physiological reactivity. However, studies have rarely controlled the nature of antipsychotic medication. Yet, the influence of these drugs on emotional response is uncertain and could vary depending on their pharmacological profile.


OBJECTIVE
This prospective and randomized study aimed to compare the effects of an atypical antipsychotic, risperidone, to a typical one, haloperidol, on patients' emotional responding during an emotional induction task.


METHODS
Twenty-five schizophrenic patients underwent two emotional and clinical evaluations: one before treatment initiation and a second 4 weeks after. Emotional states of fear, sadness, anger, joy, and disgust were induced, as well as a neutral baseline state. Video recordings of patients during the induction task allowed for assessment of emotional expressiveness. Self-reports and measures of skin conductance and heart rate were performed to determine both subjective and physiological reactions to emotional experience.


RESULTS
Compared to haloperidol, risperidone did not reduce patients' facial expressiveness, decreased physiological reactivity, and decreased experience of unpleasant emotion but maintained experience of pleasant emotion. Emotional expressiveness was negatively correlated to parkisonism.


CONCLUSIONS
Our preliminary results suggest that atypical antipsychotics allow for better-adapted patterns of emotional responding than typical ones do. We suggest that this effect is due to reduced striatal D2 blockade, therefore, attenuating akinesia, coupled with increased 5HT and DA levels in prefrontal cortex, which improves emotional regulation.
Fakra
E
E
CIC-UPCET et Pharmacologie Clinique, Hôpital de la Timone, UMR CNRS 6193 Institut des Neurosciences Cognitives de la Méditerranée, Marseille, France. eric.fakra@ap-hm.fr
Khalfa
S
S
Da Fonseca
D
D
Besnier
N
N
Delaveau
P
P
Azorin
J M
JM
Blin
O
O
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000494:pharmacology*; D003342:Corpus Striatum / Q000187:drug effects / Q000378:metabolism; D004298:Dopamine / Q000378:metabolism; D065127:Dopamine D2 Receptor Antagonists; D004644:Emotions / Q000187:drug effects*; D005149:Facial Expression; D005260:Female; D006220:Haloperidol / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018967:Risperidone / Q000494:pharmacology*; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012701:Serotonin / Q000378:metabolism; D014741:Video Recording; D055815:Young Adult
D014150:Antipsychotic Agents; D065127:Dopamine D2 Receptor Antagonists; D012701:Serotonin; D006220:Haloperidol; D018967:Risperidone; D004298:Dopamine