Effect of risperidone versus haloperidol on emotional responding in schizophrenic patients

CIC-UPCET et Pharmacologie Clinique, Hôpital de la Timone, UMR CNRS 6193 Institut des Neurosciences Cognitives de la Méditerranée, Marseille, France.
Psychopharmacology (Impact Factor: 3.88). 07/2008; 200(2):261-72. DOI: 10.1007/s00213-008-1203-y
Source: PubMed

ABSTRACT Studies on emotional processing report that schizophrenic patients present a specific pattern of emotional responding that usually includes deficits in emotional expressiveness, increased feelings of unpleasant emotion but decreased feelings of pleasant emotion, and increased physiological reactivity. However, studies have rarely controlled the nature of antipsychotic medication. Yet, the influence of these drugs on emotional response is uncertain and could vary depending on their pharmacological profile.
This prospective and randomized study aimed to compare the effects of an atypical antipsychotic, risperidone, to a typical one, haloperidol, on patients' emotional responding during an emotional induction task.
Twenty-five schizophrenic patients underwent two emotional and clinical evaluations: one before treatment initiation and a second 4 weeks after. Emotional states of fear, sadness, anger, joy, and disgust were induced, as well as a neutral baseline state. Video recordings of patients during the induction task allowed for assessment of emotional expressiveness. Self-reports and measures of skin conductance and heart rate were performed to determine both subjective and physiological reactions to emotional experience.
Compared to haloperidol, risperidone did not reduce patients' facial expressiveness, decreased physiological reactivity, and decreased experience of unpleasant emotion but maintained experience of pleasant emotion. Emotional expressiveness was negatively correlated to parkisonism.
Our preliminary results suggest that atypical antipsychotics allow for better-adapted patterns of emotional responding than typical ones do. We suggest that this effect is due to reduced striatal D2 blockade, therefore, attenuating akinesia, coupled with increased 5HT and DA levels in prefrontal cortex, which improves emotional regulation.

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Available from: David Da Fonseca, Feb 02, 2015
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    • "Summarizing, thus far mixed results regarding cardiac responding in schizophrenia have been reported. However, none of these studies have taken medication use into account, while it has previously been found that atypical antipsychotics decrease physiological responding to emotion-eliciting stimuli [18]. The aim of the present study is to broaden our knowledge about the cardiac responding and underlying motivations of patients with schizophrenia while viewing emotion-eliciting pictures. "
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    ABSTRACT: Previous research investigating the emotion recognition ability in patients with schizophrenia has mainly focused on the recognition of facial expressions. To broaden our understanding of emotional processes in patients with schizophrenia, this study aimed to investigate whether these patients experience and process other emotionally evocative stimuli differently from healthy participants. To investigate this, we measured the cardiac and subjective responses of 33 male patients (9 with and 24 without antipsychotic medication) and 40 male control subjects to emotion-eliciting pictures. Cardiac responses were chosen as an outcome measure because previous research has indicated that these are linked with attentional and emotional processes and provide a more objective measure than self-report measures alone. The differences in cardiac responses between patients and controls were limited to medicated patients: only the medicated patients showed significantly decreased cardiac orienting responses compared with control subjects, regardless of picture contents. These results indicate that medicated patients directed less attention towards emotion-eliciting pictures than controls. Decreased attentional resources while processing emotional evocative stimuli could lead to incorrect appraisals of the environment and may have detrimental emotional and social consequences, contributing to chronic stress levels and an increased risk for cardiovascular disease.
    Cardiovascular Psychiatry and Neurology 11/2012; 2012:858562. DOI:10.1155/2012/858562
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    • "Such studies are needed to further our understanding of whether the emotion impairments are specific to facial expressions, or are rather a symptom of a more global process relating to emotional stimuli. With respect to medications, further examination across longitudinal outcomes and other medications are necessary, including the examination of typical vs. atypical neuroleptics (Juckel et al., 2006; Fakra et al., 2008, 2009) and other antidepressant treatments . It is also important to examine the effects of SSRIs separately, which was not possible in this study due to the small subset of participants that were taking SSRIs only. "
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    ABSTRACT: Facial emotion recognition impairments have been reported in Huntington's disease (HD). However, the nature of the impairments across the spectrum of HD remains unclear. We report on emotion recognition data from 344 participants comprising premanifest HD (PreHD) and early HD patients, and controls. In a test of recognition of facial emotions, we examined responses to six basic emotional expressions and neutral expressions. In addition, and within the early HD sample, we tested for differences on emotion recognition performance between those 'on' vs. 'off' neuroleptic or selective serotonin reuptake inhibitor (SSRI) medications. The PreHD groups showed significant (p<0.05) impaired recognition, compared to controls, on fearful, angry and surprised faces; whereas the early HD groups were significantly impaired across all emotions including neutral expressions. In early HD, neuroleptic use was associated with worse facial emotion recognition, whereas SSRI use was associated with better facial emotion recognition. The findings suggest that emotion recognition impairments exist across the HD spectrum, but are relatively more widespread in manifest HD than in the premanifest period. Commonly prescribed medications to treat HD-related symptoms also appear to affect emotion recognition. These findings have important implications for interpersonal communication and medication usage in HD.
    10/2012; 207(1-2). DOI:10.1016/j.psychres.2012.09.022
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    ABSTRACT: This study determined medical service utilization and costs associated with switching to risperidone from previous treatment with typical antipsychotic agents. 62 adult outpatients diagnosed with schizophrenia were identified from pharmacy records, with complete information regarding medical service utilization for one year before and after treatment with risperidone. Information on hospitalization, use of day care hospital, electroconvulsive therapy, emergency department, outpatient clinic services and functional parameters were collected. Cost of treatment, cost of unemployment and cost of lost productivity due to suicide were calculated. The results showed significant fewer hospitalization days, ECT sessions and emergency department visits were observed one year after switching to risperidone (p<.05). The total treatment costs associated with risperidone after one year was 88.8% higher than costs during the previous year of treatment with typical antipsychotic agents.
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