A functional serotonin transporter (5-HTT) polymorphism is associated with psychosis in neuroleptic-free schizophrenics

A. K. Malhotra, D. Goldman, C. Mazzanti, A. Clifton, A. Breier, D. Pickar

Research output: Contribution to journalArticlepeer-review

117 Scopus citations


The neurotransmitter serotonin has been implicated in the pathophysiology of psychosis. The serotonin transporter (5-HTT) plays a critical role in regulation of serotonergic function. A recently identified polymorphism in the promoter region of the 5-HTT gene (5-HTTLPR) produces significant differences in 5-HTT expression and function and was found to be associated with anxiety-related traits in healthy volunteers. We investigated whether 5-HTTLPR is associated with psychosis in neuroleptic-free schizophrenic or schizoaffective patients. Fifty patients with schizophrenia or schizoaffective disorder by DSM-III-R criteria were genotyped at 5-HTTLPR and underwent double-blind Brief Psychiatric Rating Scale (BPRS) ratings while neuroleptic-free for approximately 4 weeks. Patients with the 5-HTTLPR II genotype (n = 19) had significantly higher BPRS ratings for psychosis than patients with the ls (n = 25) or ss (n = 6) genotypes. Examination of individual items revealed a specific significant increase in intensity of hallucinations in patients with the 5-HTTLPR II genotype. These data provide preliminary evidence for a role of serotonin in the pathophysiology of hallucinations and may represent the identification of an allelic variant that modifies the complex clinical presentation of schizophrenia.

Original languageEnglish (US)
Pages (from-to)328-332
Number of pages5
JournalMolecular Psychiatry
Issue number4
StatePublished - 1998
Externally publishedYes


  • Gene
  • Hallucinations
  • Polymorphism
  • Psychosis
  • Schizophrenia
  • Serotonin

ASJC Scopus subject areas

  • Molecular Biology
  • Psychiatry and Mental health


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