The effect of second-generation antipsychotics on hippocampal volume in first episode of psychosis: longitudinal study

Background Current neuroscience literature has related treatment with aripiprazole to improved memory performance and subcellular changes in the hippocampus. Aims To explore the volumetric changes in hippocampal grey matter in people with a first episode of psychosis (FEP) treated with second-generation antipsychotics. Method Baseline and 1-year follow-up magnetic resonance images were obtained. Hippocampal volumes were estimated by using FreeSurfer and MAGeT-Brain. Subgroups included: aripiprazole (n= 13), olanzapine (n= 12), risperidone/paliperidone (n= 24), refused-antipsychotics (n= 13) and controls (n= 44). Results Aripiprazole subgroup displayed significant increases in bilateral hippocampal volume compared with all other subgroups (FreeSurfer: all P's< 0.012; MAGeT-Brain: all P's< 0.040). Conclusions Aripiprazole is a first-line, second-generation treatment option that may provide an added benefit of pro-hippocampal growth. The biological underpinnings of these changes should be the focus of future investigations and may be key towards achieving a better clinical outcome for more individuals. Copyright and usage (C) The Royal College of Psychiatrists 2016.