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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1243

Antipsychotic-induced changes in mitochondrial bioenergetics in schizophrenia: evidence from a randomized controlled trial

ANTIPSYCHOTIC INDUCED MITOCHONDRIAL BIOENERGETIC MODULATION IN SCHIZOPHRENIA: EVIDENCE FROM A RANDOMIZED CONTROLLED TRIAL

Patients with schizophrenia exhibited mitochondrial bioenergetic dysfunction at baseline. While 12 weeks of risperidone and aripiprazole treatment improved symptoms, both drugs produced measurable changes in mitochondrial parameters, with no significant differences between the two drugs.

The study aimed to evaluate and compare the effects of risperidone and aripiprazole on mitochondrial dysfunction in schizophrenia. This randomized, open-label, parallel-group clinical trial included 60 patients with schizophrenia and 30 healthy controls; 108 individuals were assessed for eligibility, and 48 were excluded (41 did not meet the criteria and 7 declined to participate). Patients were randomized to risperidone 2–6 mg/day (n = 30) or aripiprazole 10–20 mg/day (n = 30) and followed for 12 weeks. The primary outcome was platelet mitochondrial respiratory chain complex I (MRCC-I) activity; secondary outcomes were serum lactate, serum pyruvate, the lactate:pyruvate (L:P) ratio, creatine kinase, PANSS, response rate, NMDAS, and adverse events. Four patients in the risperidone arm and five in the aripiprazole arm were lost to follow-up; intention-to-treat analyses were performed with n = 30 in each arm using R. At baseline, patients with schizophrenia had higher MRCC-I activity, lactate, pyruvate, and L:P ratios than healthy volunteers (p < 0.0001 for platelet MRCC-I), while creatine kinase levels were similar; there were no significant baseline differences between the two treatment arms (all p > 0.05). After 12 weeks, platelet MRCC-I activity decreased in both arms (p < 0.0001), serum lactate increased (p < 0.0001), serum pyruvate remained unchanged, the L:P ratio increased, and creatine kinase increased in the risperidone arm. Clinically, PANSS total scores decreased in both arms (p < 0.0001), NMDAS scores remained unchanged, and response rates were similar. Between-group differences in changes were not significant (p = 0.508 for MRCC-I; p = 0.135 for serum lactate; p = 0.625 for PANSS total score); the treatments were well tolerated, and no significant between-group differences in safety were observed. In conclusion, schizophrenia is associated with mitochondrial bioenergetic abnormalities at baseline, and while both atypical antipsychotics improve symptoms, they produce measurable changes in mitochondrial bioenergetics that do not differ between the drugs.

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