The Influence of Antipsychotic Treatment on Brain Reward System Reactivity in Schizophrenia Patients
Abstract
INTRODUCTION: Neuroleptic dysphoria is discussed as a serious side effect of antipsychotic medication. One aspect of this condition, a reduced motivation to reach potential rewards, might be induced by a blockade of striatal D2 receptors resulting in a reduced reactivity of the brain reward system. However, since this D2 antagonistic effect is higher for typical than atypical antipsychotics, typical antipsychotics should induce a stronger dampening of brain reward system activation. This hypothesis was tested in an event related functional magnetic resonance imaging study. METHODS: A monetary reward paradigm was presented to 30 schizophrenia patients, who were treated with typical or atypical antipsychotics or a combination of both. Hemodynamic responses were analyzed during the anticipation and the reception of the reward. RESULTS: Activation of the right ventral striatum, a core region of the brain reward system, was lower in patients treated with typical antipsychotics but only during the anticipation and not the delivery of a monetary reward. DISCUSSION: This result indicates that a D2 associated reduction of brain reward system reactivity might be the neurobiological correlate of reduced motivation observed in the context of neuroleptic dysphoria. Using typical antipsychotics might worsen this effect, increasing the negative symptomatology of schizophrenia patients.
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Neuroimaging studies generally suggest decreased NAc activation during monetary-reward anticipation in schizophrenia in both medicated and unmedicated patients.
“Neuroimaging studies of responses to rewards in schizophrenia generally suggest decreased NAc activation during monetary-reward anticipation (but see [416]for an exception) in both patients taking medication and patients not taking medication [417-420].”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [418]
Striatal responses during monetary anticipation in schizophrenia are partially normalized by olanzapine but not by other antipsychotics.
“A handful of studies also suggest that striatal responses during monetary anticipation in schizophrenia are partially normalized by the antipsychotic, olanzapine [279,417,423] but not by other antipsychotics [418]”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [418]
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- Authors
- Kirsch, P., Ronshausen, S., Mier, D., & Gallhofer, B.
- Affiliations
- Justus-Liebig-Universität Gießen (DE)
- ORCID
- Venue
- Pharmacopsychiatry
- Publisher
- Georg Thieme Verlag KG
- Published
- 2007-09
- Volume
- 40
- Issue
- 5
- Pages
- 196-198
- ISSN
- 0176-3679 (ISSN-L)
- 1439-0795
- OpenAlex
- W1975417628
- Cited by
- 95
- References
- 0
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- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pharmacopsychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- antipsychotic adverse effects, brain reward system, ventral striatum, dopamine D2 receptor blockade, typical antipsychotics, atypical antipsychotics, motivation, schizophrenia, negative symptoms
- MeSH terms
- Adult, Brain, Cerebrovascular Circulation, Humans, Magnetic Resonance Imaging, Male, Motivation, Psychomotor Performance, Reward, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Neostriatum, Receptors, Dopamine D2
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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