The effects of neuroleptic medications on basal ganglia blood flow in schizophreniform disorders: a comparison between the neuroleptic-naïve and medicated states

Biol Psychiatry. 2002 Nov 1;52(9):855-62. doi: 10.1016/s0006-3223(02)01421-x.


Background: Previous studies indicate that basal ganglia volumes of first-episode neuroleptic-naïve patients with schizophrenia are smaller than those of normal control subjects. Subsequent exposure to neuroleptic medication appears to induce volumetric change. Possible reasons for this include differences in blood flow and metabolism between the neuroleptic-naïve and medicated states.

Methods: We used positron emission tomography (PET) to measure blood flow to the caudate and putamen, in a sample of 29 neuroleptic-naïve patients with schizophreniform disorders and 29 matched control subjects. We also studied a subset of the patient sample (n = 13), comparing their "before" versus "on" medication PET scans.

Results: We did not find a significant difference in blood flow to the caudate and putamen between neuroleptic-naïve patients and control subjects even after controlling for whole brain blood flow; however, in the subset of 13 patients compared in the "on" versus "off" medication states, there was a statistically significant increase in blood flow to both the caudate and putamen.

Conclusions: Before treatment, there appears to be no difference in striatal blood flow between first-episode neuroleptic-naïve patients and healthy volunteers, but there appears to be a significant increase in blood flow to the striatum after the treatment is initiated.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antipsychotic Agents / pharmacology
  • Antipsychotic Agents / therapeutic use*
  • Basal Ganglia / blood supply*
  • Basal Ganglia / drug effects*
  • Cerebrovascular Circulation / physiology
  • Female
  • Follow-Up Studies
  • Haloperidol / pharmacology
  • Haloperidol / therapeutic use
  • Humans
  • Male
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / metabolism*
  • Psychotic Disorders / pathology
  • Putamen / blood supply
  • Putamen / drug effects
  • Putamen / pathology
  • Retrospective Studies
  • Risperidone / pharmacology
  • Risperidone / therapeutic use
  • Tomography, Emission-Computed


  • Antipsychotic Agents
  • Haloperidol
  • Risperidone