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Oxidative Stress During Treatment With First- and Second-Generation Antipsychotics

Received August 4, 2003; revised December 8, 2003; accepted March 16, 2004. From the Department of Clinical Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany; the Department of Psychiatry and Psychotherapy, University Göttingen, Göttingen, Germany; the Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany; the Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Nuremberg, Germany. Address correspondence to Dr. Kropp, Klinische Psychiatrie und Psychotherapie, Medizinische Hochschule Hannover, OE 7117, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; kropp.stefan{at}mh-hannover.de (E-mail).

Neurotoxicity of first-generation antipsychotics (FGAs) may be involved in lipid peroxidation, which is the pathogenesis of extrapyramidal symptoms, including tardive dyskinesia (TD). Blood samples at day 0, 7, and 21 drawn from patients taking antipsychotics were analyzed for malondialdehyde (MDA) in plasma, a marker of lipid peroxidation, by high-performance liquid chromatography. Of 115 patients enrolled, 92 patients completed the study. Most MDA levels were within normal ranges (<1.0 µmol/liter). Malondialdehyde levels in patients receiving clozapine (p=0.002), quetiapine (p=0.003), amisulpride (p=0.008), and risperidone (p=0.008) were significantly lower than within the first generation antipsychotic group. The authors conclude that lipid peroxidation is significantly higher in treatment with FGAs.

Key Words: oxidative stress • antipsychotics • malondialdehyde

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