Effect of risperidone versus haloperidol on emotional responding in schizophrenic patients
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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.
Materials and methods
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.
KeywordsSchizophrenia Antipsychotic agents Emotion Facial expressions Emotional experience Physiological responses Serotonin Dopamine Prefrontal cortex
- Casey DE (2004) Pathophysiology of antipsychotic drug-induced movement disorders. J Clin Psychiatry 65 Suppl 9:25–28Google Scholar
- Chouinard G, Ross-Chouinard A, Annable L, Jones B (1980) The extra-pyramidal symptom rating scale. Can J Neurol Sci 7:233Google Scholar
- de Haan L, van Bruggen M, Lavalaye J, Booij J, Dingemans PM, Linszen D (2003) Subjective experience and D2 receptor occupancy in patients with recent-onset schizophrenia treated with low-dose olanzapine or haloperidol: a randomized, double-blind study. Am J Psychiatry 160:303–309PubMedCrossRefGoogle Scholar
- DSM-IV-TR (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revised (DSM-IV-TR). In: Association AP (ed), Washington, DC, pp 803–805Google Scholar
- Fahrenberg J (1988) Psychophysiological processes. In: Nesselroade JR, Cattell RB (eds) Handbook of multivariate experimental psychology, 2nd edn. Plenum, New York, pp 867–914Google Scholar
- Fakra E, Salgado-Pineda P, Besnier N, Azorin JM, Blin O (2007) Risperidone versus haloperidol for facial affect recognition in schizophrenia: findings from a randomised study. World J Biol Psychiatry 10:1–10Google Scholar
- First MB, Spitzer RL, Gibbon M, Williams JBW (1994) Structured Clinical Interview for DSM-IV—Patient Version. Biometrics Research Department, New York State Psychiatric Institute, New YorkGoogle Scholar
- Gerrards-Hesse A, Spies K, Hesse FW (1994) Experimental inductions of emotional states and their effectiveness: a review. Br J Psychol 85:55–78Google Scholar
- Izard CE (1972) Patterns of emotions: a new analysis of anxiety and depression. Academic, New YorkGoogle Scholar
- Kornreich C, Philippot P, Verpoorten C, Dan B, Baert I, Le Bon O, Verbanck P, Pelc I (1998) Alcoholism and emotional reactivity: more heterogeneous film-induced emotional response in newly detoxified alcoholics compared to controls—a preliminary study. Addict Behav 23:413–418PubMedCrossRefGoogle Scholar
- Lane RD, McRae K (2004) Neural substrates of conscious emotional experience: a cognitive-neuroscientific perspective. In: Beauregard M (ed) Consciousness, emotional self-regulation and the brain. John Benjamins, Amsterdam, The Netherlands, pp 87–122Google Scholar
- Leucht S, Pitschel-Walz G, Abraham D, Kissling W (1999) Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomized controlled trials. Schizophr Res 35:51–68PubMedCrossRefGoogle Scholar