To date numerous in-vivo P-31-MRS and in-vitro studies in schizophrenic pat
ients have been able to demonstrate changes in their membrane phospholipid
metabolism, which might be relevant for the cause and the therapeutic respo
nsiveness of this disorder. Thus far, however, only limited studies exist r
egarding the specificity of these findings for schizophrenia and the effect
of antipsychotic medication. The present study examined the composition of
membrane phospholipids in platelets of 67 neuroleptic-free schizophrenic p
atients compared to healthy and psychiatric controls. In a subsample of the
schizophrenic patients we determined the effect of antipsychotic treatment
on the phospholipid metabolism during six-months follow up. While untreate
d patients showed a decrease in major membrane phospholipid components, i.e
. phosphatidylcholine and phosphatidylethanolamine, when compared to contro
l subjects, as well as an increase in their breakdown-product lysophosphati
dylcholine (LPC), there was a significant reduction in LPC during three wee
ks of pharmacotherapy with haloperidol. After six months treatment with dif
ferent antipsychotics some divergent effects on phospholipid metabolism in
schizophrenic patients could be demonstrated. While in the long-term course
LPC remained decreased under continuous therapy with typical neuroleptics,
patients being treated with the atypical drug zotepine showed an increase
in LPC compared to their baseline level before therapy. Thus, specific mech
anisms of the different antipsychotic therapies on phospholipid metabolism
might serve to explain the divergent findings of P-31-MRS in medicated pati
ents.