title: The effect of atypical antipsychotics on brain N-acetylaspartate levels in antipsychotic-naïve first-episode patients with schizophrenia: a preliminary study.
abstract: OBJECTIVE
  To investigate the correlates of a clinical therapeutic response by using the parameters measured by proton magnetic resonance spectroscopy after the administration of atypical antipsychotics.
  
  
  METHODS
  Twenty-five antipsychotic-naïve first-episode patients with schizophrenia were monitored for 12 months. The patients were evaluated using (1)H magnetic resonance spectroscopy in the dorsolateral prefrontal cortex and Positive and Negative Syndrome Scale, Clinical Global Impression Scale of Severity, Tower of London - Drexel University, Letter-Number Span Test, Trail Making Test A, and Personal and Social Performance Scale. They were administered atypical antipsychotics, starting with quetiapine. In the absence of a therapeutic response, another antipsychotic was introduced.
  
  
  RESULTS
  After 12 study months, the N-acetylaspartate/creatine (NAA/Cr) level did not significantly change at the whole-group level. Additional analysis revealed a significant rise in the NAA/Cr level in the study group that stayed on the same antipsychotic throughout the study course (P=0.008) and a significant drop in NAA/Cr in the study group that switched antipsychotics (P=0.005). On the whole-group level, no significant correlations between NAA/Cr values and other scores were found at either baseline or after 12 study months.
  
  
  CONCLUSIONS
  One-year treatment with atypical antipsychotics administered to antipsychotic-naïve patients didn't result in a significant rise in the NAA/Cr ratio. However, a significant rise was witnessed in the study group in which a satisfactory therapeutic response had been achieved with a single antipsychotic administration.
authors.affiliation: Psychiatric Hospital Sveti Ivan, University of Zagreb, Zagreb, Croatia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Grošić
authors.affiliation: University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia.
authors.forename: Petra
authors.initials: P
authors.lastname: Folnegović Grošić
authors.affiliation: Polyclinic Neuron, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia ; Department of Neuropharmacology and Behavioral Pharmacology, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia.
authors.forename: Petra
authors.initials: P
authors.lastname: Kalember
authors.affiliation: University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia.
authors.forename: Maja
authors.initials: M
authors.lastname: Bajs Janović
authors.affiliation: Polyclinic Neuron, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia ; Department of Neuropharmacology and Behavioral Pharmacology, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia.
authors.forename: Marko
authors.initials: M
authors.lastname: Radoš
authors.affiliation: Psychiatric Hospital Sveti Ivan, University of Zagreb, Zagreb, Croatia.
authors.forename: Mate
authors.initials: M
authors.lastname: Mihanović
authors.affiliation: Polyclinic Neuron, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia ; Vrapče University Hospital, University of Zagreb, Zagreb, Croatia.
authors.forename: Neven
authors.initials: N
authors.lastname: Henigsberg
keywords: MRS; NAA; atypical antipsychotics; schizophrenia