Effects of clozapine and olanzapine on cortical thickness in childhood-onset schizophrenia.
BACKGROUND
Little is known about the effects of antipsychotic medications on gray matter (GM) in schizophrenia. Although clozapine remains the most effective antipsychotic medication in treatment-refractory cases, it is unknown whether it has a differential effect on GM development.


METHODS
In an exploratory analysis, we used automated cortical thickness measurements and prospectively scanned childhood-onset schizophrenia (COS) patients who were maintained on one medication. Two atypical antipsychotic medications, clozapine (n=12, 37 scans) and olanzapine (n=12, 33 scans) were compared with respect to effects on cortical development, in contrast to GM trajectories of matched controls.


RESULTS
There were no significant differences in the trajectories of cortical thickness between the two treatment groups with the exception of a small circumscribed area in the right prefrontal cortex, where the olanzapine group showed thicker cortex. As expected, both groups showed thinner GM compared to matched controls.


CONCLUSIONS
Although these analyses do not rule out effects of antipsychotic medications on GM development in schizophrenia, they show no differential effect between clozapine and olanzapine on GM trajectory.
Mattai
Anand
A
Child Psychiatry Branch, NIMH, NIH, Bethesda, MD, 20892-1600, United States. mattaia@mail.nih.gov
Chavez
Alex
A
Greenstein
Deanna
D
Clasen
Liv
L
Bakalar
Jennifer
J
Stidd
Reva
R
Rapoport
Judith
J
Gogtay
Nitin
N
D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000187:drug effects / Q000473:pathology; D003024:Clozapine / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D000077152:Olanzapine; D011569:Psychiatric Status Rating Scales; D012561:Schizophrenia, Childhood / Q000188:drug therapy* / Q000473:pathology; D012720:Severity of Illness Index
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D003024:Clozapine; D000077152:Olanzapine