D2 dopamine receptor up-regulation, treatment response, neurological soft signs, and extrapyramidal side effects in schizophrenia: a follow-up study with 123I-iodobenzamide single photon emission computed tomography in the drug-naive state and after neuroleptic treatment.

Schröder, J; Silvestri, S; Bubeck, B; Karr, M; Demisch, S; Scherrer, S; Geider, F J; Sauer, H

Schröder, J; Silvestri, S; Bubeck, B; Karr, M; Demisch, S; Scherrer, S; Geider, F J; Sauer, H.

Afiliación

Schröder J; Department of Psychiatry, University of Heidelberg, Germany.

Biol Psychiatry ; 43(9): 660-5, 1998 May 01.

Article en En | MEDLINE | ID: mdl-9582999

RESUMEN

BACKGROUND: Animal and postmortem studies indicate that neuroleptic therapy may induce D2 dopamine receptor up-regulation in the basal ganglia. METHODS: To address this phenomenon in a clinical study, we investigated the D2 dopamine receptor binding in 15 DSM-III-R schizophrenics in the drug-naive state and 3 days after completion of a standardized neuroleptic therapy (benperidol 12-16 mg/day, for 25 days) using single photon emission computed tomography (SPECT). SPECT scans were obtained 2 hours after intravenous injection of 185 MBq 123I-iodobenzamide. For analysis, basal ganglia to frontal cortex (BG/FC) ratios were calculated and the patient sample was subgrouped into patients with a favorable versus a poor treatment response. RESULTS: Neuroleptic treatment led to decreased BG/FC ratios in patients with a favorable response, but increased ratios in the poor responders (df = 1, F = 4.1, p = .06). Changes of BG/FC ratios were significantly correlated with extrapyramidal side effects but not with neurological soft signs. CONCLUSIONS: Our findings suggest that neuroleptic therapy may induce D2 dopamine receptor up-regulation in a subgroup of patients characterized by poor treatment response and pronounced extrapyramidal side effects.

Asunto(s)

Antipsicóticos/uso terapéutico; Enfermedades de los Ganglios Basales/diagnóstico por imagen; Receptores de Dopamina D2/biosíntesis; Esquizofrenia/tratamiento farmacológico; Esquizofrenia/metabolismo; Regulación hacia Arriba/efectos de los fármacos; Adulto; Ganglios Basales/diagnóstico por imagen; Enfermedades de los Ganglios Basales/inducido químicamente; Femenino; Estudios de Seguimiento; Humanos; Radioisótopos de Yodo; Masculino; Persona de Mediana Edad; Pruebas Neuropsicológicas; Escalas de Valoración Psiquiátrica; Receptores de Dopamina D2/efectos de los fármacos; Esquizofrenia/diagnóstico por imagen; Psicología del Esquizofrénico; Tomografía Computarizada de Emisión de Fotón Único

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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Esquizofrenia / Antipsicóticos / Enfermedades de los Ganglios Basales / Regulación hacia Arriba / Receptores de Dopamina D2 Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Biol Psychiatry Año: 1998 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos

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