Open Access Highly Accessed Open Badges Research article

Effects of typical and atypical antipsychotic drugs on gene expression profiles in the liver of schizophrenia subjects

Kwang H Choi1*, Brandon W Higgs2, Serge Weis13, Jonathan Song1, Ida C Llenos13, Jeannette R Dulay13, Robert H Yolken4 and Maree J Webster1

Author Affiliations

1 Stanley Laboratory of Brain Research, Rockville, MD 20850, USA

2 Elashoff Consulting, Redwood City, CA 94065, USA

3 Departments of Psychiatry and Pathology, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA

4 Stanley Laboratory of Developmental Neurovirology, Johns Hopkins University, School of Medicine, 600 North Wolfe Street, Blalock 1105, Baltimore, MD 21287, USA

For all author emails, please log on.

BMC Psychiatry 2009, 9:57  doi:10.1186/1471-244X-9-57

Published: 16 September 2009



Although much progress has been made on antipsychotic drug development, precise mechanisms behind the action of typical and atypical antipsychotics are poorly understood.


We performed genome-wide expression profiling to study effects of typical antipsychotics and atypical antipsychotics in the postmortem liver of schizophrenia patients using microarrays (Affymetrix U133 plus2.0). We classified the subjects into typical antipsychotics (n = 24) or atypical antipsychotics (n = 26) based on their medication history, and compared gene expression profiles with unaffected controls (n = 34). We further analyzed individual antipsychotic effects on gene expression by sub-classifying the subjects into four major antipsychotic groups including haloperidol, phenothiazines, olanzapine and risperidone.


Typical antipsychotics affected genes associated with nuclear protein, stress responses and phosphorylation, whereas atypical antipsychotics affected genes associated with golgi/endoplasmic reticulum and cytoplasm transport. Comparison between typical antipsychotics and atypical antipsychotics further identified genes associated with lipid metabolism and mitochondrial function. Analyses on individual antipsychotics revealed a set of genes (151 transcripts, FDR adjusted p < 0.05) that are differentially regulated by four antipsychotics, particularly by phenothiazines, in the liver of schizophrenia patients.


Typical antipsychotics and atypical antipsychotics affect different genes and biological function in the liver. Typical antipsychotic phenothiazines exert robust effects on gene expression in the liver that may lead to liver toxicity. The genes found in the current study may benefit antipsychotic drug development with better therapeutic and side effect profiles.