Cerebral metabolic changes induced by clozapine in schizophrenia and related to clinical improvement

Psychopharmacology
Vicente MolinaTomás Palomo

Abstract

The study of the different effects on brain metabolism between typical and atypical antipsychotics would aid in understanding their mechanisms of action. Clozapine is of special interest, since it is one of the most effective antipsychotic drugs and demonstrates a distinctive mechanism of action in pre-clinical studies with respect to typical neuroleptics. To study the differences in cerebral activity induced by clozapine as compared to those produced by haloperidol. [18F]Fluoro-deoxy-glucose (FDG)-positron emission tomography (PET) scans were obtained in the resting condition before and after 6 months of treatment with clozapine in 22 treatment-resistant patients with schizophrenia. Before inclusion, patients had been chronically treated with classical drugs, and all of them received haloperidol during the last month. Data were analyzed with statistical parametric mapping (SPM'99) methods, comparing pre-treatment and post-treatment conditions. The association between the changes in symptom scores and metabolism was also assessed to corroborate the functional relevance of possible metabolic changes. Clozapine decreased prefrontal and basal ganglia activity, and increased occipital metabolism, including primary and association v...Continue Reading

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