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Differential Effects of Antipsychotic Drugs on Pituitary Volume: A MRI Study

This study examines how antipsychotic medications impact pituitary volume, leveraging MRI scans to measure changes in patients during treatment. Analyses focused on various patient groups, including treatment-naïve individuals with first-episode psychosis, OCD, MDD, and ADHD. Results indicate a significant increase in pituitary volume for those treated with antipsychotics, particularly risperidone, highlighting the structural alterations linked to these drugs. Findings suggest that pituitary volume could serve as a biomarker for neuroendocrine dysfunction in mental health treatment.

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Differential Effects of Antipsychotic Drugs on Pituitary Volume: A MRI Study

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  1. Introduction • Rhonda El-Sheikh • Department of Psychiatry and Behavioral Neuroscience • Brain Research And Imaging Neuroscience • Background • MS in Biomedical Engineering, Neurophysiology minor, May 2004 • Wayne State University • BS in Computer Science, Telecommunications minor, December 2000 • Michigan State University

  2. Introduction • Main Focus • Magnetic Resonance Spectroscopy (MRS) • Quantifying both 31P, and 1H MRS data • Morphometrics • Collecting volumetric data based on a region-of-interest (ROI) approach • Using a Talairach-Brodmann atlas to refine ROI definitions of Brodmann areas in vivo

  3. Differential Effects of Antipsychotic Drugs on Pituitary Volume Rhonda M. El-Sheikh1, Frank P. MacMaster1, Ameet R. Upadhyaya1, Jeffrey Nutche2, David R. Rosenberg1, Matcheri S. Keshavan1; 1Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, 2Western Psychiatric Institute & Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 1st June, 2005

  4. Objective • To examine the effect of antipsychotics on pituitary volume • Antipsychotics are known to affect pituitary function leading to robust prolactin elevations • Increased prolactin may be associated with structural alterations in pituitary volume

  5. Methods • Using structural magnetic resonance imaging (MRI) scans, pituitary volumes were measured in a series of five samples • A. Before and after treatment samples • PSY: Treatment naïve first episode psychotic patients (primarily taking risperidone or olanzapine) • OCD: Obsessive compulsive disorder patients • MDD: Major depressive disorder patients • ADHD: Attention deficit hyperactivity disorder patients • B. Unmedicated healthy controls

  6. Sample Information and Change in Pituitary Volume *Significant at p < 0.05

  7. Results • Pituitary volume significantly increased in the PSY subjects after successful treatment, as opposed to healthy controls • t[17] = 2.44, p = 0.026, 11% increase; 1% increase respectively • Risperidone produced larger increases in pituitary volume as opposed to olanzapine • 13% increase; 3% increase respectively • There was no effect of treatment noted in the OCD, MDD and ADHD groups, despite symptomatic improvement

  8. Conclusions • Pituitary volume increases appear specific to antipsychotic treatments, especially prolactin elevating drugs (i.e. risperidone) in contrast to prolactin sparing drugs (i.e. olanzapine) • Pituitary volumes may be a biomarker for treatment related neuroendocrine dysfunctions • Future studies should combine neuroendocrine measures with pituitary volumetric measures

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