Antipsychotics, dopamine D-2 receptor occupancy and clinical improvement in schizophrenia: A meta-analysis

作者：Yilmaz Zeynep; Zai Clement C; Hwang Rudi; Mann Steve; Arenovich Tamara; Remington Gary; Daskalakis Zafiris J^*

来源：Schizophrenia Research, 2012, 140(1-3): 214-220.

DOI：10.1016/j.schres.2012.06.027

• Schizophrenia
• Dopamine D-2 receptor occupancy
• Antipsychotic medication response
• Clinical improvement
• Meta-analysis
• Neuroimaging

Objective: Treatment of schizophrenia (SCZ) was revolutionized with the development of the antipsychotic medications. Although imaging studies have linked antipsychotic D-2 receptor occupancy and clinical response in SCZ, heterogeneity between cohorts and methods has made it challenging to generalize findings across studies. The main objective of this meta-analysis was to analyze the relationship between in vivo estimation of typical and atypical antipsychotic D-2 receptor occupancy and treatment response in SCZ.
Methods: Using the keywords "dopamine D-2 receptor occupancy," "schizophrenia," "PET/SPECT" and "antipsychotics," and further refining our search to journal articles with information on % striatal D-2 occupancy and % change in clinical symptoms as indexed by either the BPRS or the PANSS, our final analysis consisted of 16 imaging studies (20 cohorts; N=206).
Results: The first step of the meta-analysis confirmed the positive relationship between antipsychotic medication and clinical improvement in SCZ (ES=1.36; 95% CI: 1.13-1.60). The second step of our analysis revealed that when D-2 occupancy was limited to less than 80% in order to control for the appearance of extrapyramidal symptoms, high D-2 occupancy was correlated with reduction in clinical scores (r=0.4, p<0.001) for medications other than clozapine or quetiapine.
Conclusions: Our results suggest that D-2 occupancy is a contributing factor for the mechanism of antipsychotic effect in SCZ for some but not all antipsychotic medications.

• 出版日期2012-9
• 单位河北医科大学