title: Divergent effects of first-generation and second-generation antipsychotics on cortical thickness in first-episode psychosis.
abstract: BACKGROUND
  Whether there are differential effects of first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) on the brain is currently debated. Although some studies report that FGAs reduce grey matter more than SGAs, others do not, and research to date is limited by a focus on schizophrenia spectrum disorders. To address this limitation, this study investigated the effects of medication in patients being treated for first-episode schizophrenia or affective psychoses.
  
  
  METHODS
  Cortical thickness was compared between 52 first-episode psychosis patients separated into diagnostic (i.e. schizophrenia or affective psychosis) and medication (i.e. FGA and SGA) subgroups. Patients in each group were also compared to age- and sex-matched healthy controls (n = 28). A whole-brain cortical thickness interaction analysis of medication and diagnosis was then performed. Correlations between cortical thickness with antipsychotic dose and psychotic symptoms were examined.
  
  
  RESULTS
  The effects of medication and diagnosis did not interact, suggesting independent effects. Compared with controls, diagnostic differences were found in frontal, parietal and temporal regions. Decreased thickness in FGA-treated versus SGA-treated groups was found in a large frontoparietal region (p < 0.001, corrected). Comparisons with healthy controls revealed decreased cortical thickness in the FGA group whereas the SGA group showed increases in addition to decreases. In FGA-treated patients cortical thinning was associated with higher negative symptoms whereas increased cortical thickness in the SGA-treated group was associated with lower positive symptoms.
  
  
  CONCLUSIONS
  Our results suggest that FGA and SGA treatments have divergent effects on cortical thickness during the first episode of psychosis that are independent from changes due to illness.
authors: Melbourne Neuropsychiatry Centre, Department of Psychiatry,University of Melbourne and Melbourne Health,Carlton South, Victoria,Australia.
authors: B R E
authors: BR
authors: Ansell
authors: Melbourne Neuropsychiatry Centre, Department of Psychiatry,University of Melbourne and Melbourne Health,Carlton South, Victoria,Australia.
authors: D B
authors: DB
authors: Dwyer
authors: Melbourne Neuropsychiatry Centre, Department of Psychiatry,University of Melbourne and Melbourne Health,Carlton South, Victoria,Australia.
authors: S J
authors: SJ
authors: Wood
authors: Melbourne Neuropsychiatry Centre, Department of Psychiatry,University of Melbourne and Melbourne Health,Carlton South, Victoria,Australia.
authors: E
authors: E
authors: Bora
authors: Orygen Youth Health Research Centre,University of Melbourne,Parkville, Victoria,Australia.
authors: W J
authors: WJ
authors: Brewer
authors: Orygen Youth Health Research Centre,University of Melbourne,Parkville, Victoria,Australia.
authors: T M
authors: TM
authors: Proffitt
authors: Melbourne Neuropsychiatry Centre, Department of Psychiatry,University of Melbourne and Melbourne Health,Carlton South, Victoria,Australia.
authors: D
authors: D
authors: Velakoulis
authors: Orygen Youth Health Research Centre,University of Melbourne,Parkville, Victoria,Australia.
authors: P D
authors: PD
authors: McGorry
authors: Melbourne Neuropsychiatry Centre, Department of Psychiatry,University of Melbourne and Melbourne Health,Carlton South, Victoria,Australia.
authors: C
authors: C
authors: Pantelis
mesh_terms: D000293:Adolescent; D000328:Adult; D000341:Affective Disorders, Psychotic / Q000188:drug therapy*; D014150:Antipsychotic Agents / Q000145:classification* / Q000627:therapeutic use*; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000033:anatomy & histology* / Q000187:drug effects*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012559:Schizophrenia / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotics; cortical thickness; first-episode psychosis; first-generation; second-generation