Journal
INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY
Volume 17, Issue 11, Pages 1729-1736Publisher
OXFORD UNIV PRESS
DOI: 10.1017/S1461145714000777
Keywords
Altanserin; antipsychotic-induced weight gain; first-episode schizophrenia; PET; quetiapine; receptor binding
Funding
- Danish Medical Research Council
- Copenhagen Hospital Cooperation Research Council
- Copenhagen University Hospital
- University of Copenhagen, Faculty of Health Sciences
- Copenhagen Council Research Foundation
- Gangsted Foundation
- Lundbeck Foundation
- Astra Zeneca
- Lundbeck Foundation [R90-2011-7722, R155-2013-16337, R62-2010-5364] Funding Source: researchfish
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Antipsychotic-induced weight gain is of major clinical importance since it is associated with severe metabolic complications and increased mortality. The serotonin2A receptor system has been suggested to be implicated in weight gain and obesity. However, no previous in vivo imaging data have related serotonin2A receptor binding to weight gain before and after antipsychotic monotherapy. Fifteen antipsychotic-naive first-episode schizophrenia patients were included and investigated before and after six months of quetiapine treatment. We examined the relationship between serotonin2A receptor binding as measured with positron emission tomography (PET) and [F-18] altanserin and change in body mass index (BMI). Quetiapine was chosen because it is characterized by a moderately high affinity for the serotonin2A receptor and a fast dissociation rate from the dopamine D-2 receptor. At baseline the mean BMI was 24.2 kg/m(2), range 18-36 kg/m(2). After six months of quetiapine treatment (mean dose: 383 mg/day) the BMI had, on average, increased by 6.7%, corresponding to an average weight gain of 5.0 kg. We found a significant positive correlation both between neocortical serotonin2A receptor binding prior to treatment and subsequent increase in BMI (rho=0.59, p=0.022). At follow-up, the serotonin2A receptor occupancy was positively correlated with BMI increase (rho=0.54, p=0.038). To our knowledge, these are the first in vivo receptor imaging data in initially antipsychotic-naive first-episode schizophrenia patients to show that the cerebral serotonin2A receptor is associated with antipsychotic-induced weight gain.
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