Antipsychotic medication, D2 dopamine receptor blockade and clinical response: a 123I IBZM SPET (single photon emission tomography) study

The hypothesis that poor response to antipsychotic medication is due to inadequate occupancy of central D2 receptors was tested in vivo. We assessed striatal D2 dopamine receptor availability for binding with the specific ligand 123I IBZM by single photon emission tomography (SPET) in two groups of...

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Bibliographic Details
Published in:Psychological medicine 1993-08, Vol.23 (3), p.791-797
Main Authors: Pilowsky, L. S., Costa, D. C., Ell, P. J., Murray, R. M., Verhoeff, N. P. L. G., Kerwin, R. W.
Format: Article
Language:English
Subjects:
Adult
Antipsychotic Agents - pharmacology
Antipsychotic Agents - therapeutic use
Basal Ganglia - diagnostic imaging
Basal Ganglia - metabolism
Benzamides - administration & dosage
Benzamides - pharmacology
Binding, Competitive
Biological and medical sciences
Corpus Striatum - diagnostic imaging
Corpus Striatum - drug effects
Corpus Striatum - metabolism
Dopamine Antagonists
Female
Humans
Injections, Intravenous
Male
Medical sciences
Neuropharmacology
Pharmacology. Drug treatments
Preliminary Communication
Psychiatric Status Rating Scales
Psycholeptics: tranquillizer, neuroleptic
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
Pyrrolidines - administration & dosage
Pyrrolidines - pharmacology
Receptors, Dopamine D2 - metabolism
Schizophrenia - diagnosis
Schizophrenia - drug therapy
Tomography, Emission-Computed, Single-Photon
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Summary:The hypothesis that poor response to antipsychotic medication is due to inadequate occupancy of central D2 receptors was tested in vivo. We assessed striatal D2 dopamine receptor availability for binding with the specific ligand 123I IBZM by single photon emission tomography (SPET) in two groups of DSM-III-R diagnosed schizophrenic patients on typical antipsychotic medication, and a group of healthy controls (N = 20). Patients were characterized by clinical ratings as antipsychotic responders (N = 10) or non-responders (N = 8). Dynamic single slice SPET, at a slice chosen to include the basal ganglia, began immediately following intravenous injection of 185 MBq 123I IBZM. Semiquantitative analysis generated indices of D2 receptor availability for binding. There was no difference in striatal D2 receptor availability between the patient groups, both showing a similar degree of occupancy by antipsychotic medication compared to the control group. Thus, poor clinical response does not appear to be accounted for by differential blockade, or inadequate occupancy of striatal dopamine D2 receptors by antipsychotic medication.
ISSN:0033-2917
1469-8978
DOI:10.1017/S0033291700025575