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

Published online by Cambridge University Press:  09 July 2009

L. S. Pilowsky ,
D. C. Costa ,
P. J. Ell ,
R. M. Murray ,
N. P. L. G. Verhoeff  and
R. W. Kerwin
L. S. Pilowsky*
Affiliation:
Institute of Psychiatry; and Institute of Nuclear Medicine, UCMSM, London; and Amsterdam Medical Centre, Cygne b.v., Eindhoven University, The Netherlands
D. C. Costa
Affiliation:
Institute of Psychiatry; and Institute of Nuclear Medicine, UCMSM, London; and Amsterdam Medical Centre, Cygne b.v., Eindhoven University, The Netherlands
P. J. Ell
Affiliation:
Institute of Psychiatry; and Institute of Nuclear Medicine, UCMSM, London; and Amsterdam Medical Centre, Cygne b.v., Eindhoven University, The Netherlands
R. M. Murray
Affiliation:
Institute of Psychiatry; and Institute of Nuclear Medicine, UCMSM, London; and Amsterdam Medical Centre, Cygne b.v., Eindhoven University, The Netherlands
N. P. L. G. Verhoeff
Affiliation:
Institute of Psychiatry; and Institute of Nuclear Medicine, UCMSM, London; and Amsterdam Medical Centre, Cygne b.v., Eindhoven University, The Netherlands
R. W. Kerwin
Affiliation:
Institute of Psychiatry; and Institute of Nuclear Medicine, UCMSM, London; and Amsterdam Medical Centre, Cygne b.v., Eindhoven University, The Netherlands
*
1Address for correspondence: Dr L. S. Pilowsky, Genetics Section, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
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Synopsis

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.

Type
Preliminary Communication
Information
Psychological Medicine , Volume 23 , Issue 3 , August 1993 , pp. 791 - 797
Copyright
Copyright © Cambridge University Press 1993

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