OBJECTIVE: Treatment of schizophrenia (SCZ) was revolutionized with the development of the antipsychotic medications. Although imaging studies have linked antipsychotic D₂ 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 D₂ receptor occupancy and treatment response in SCZ. METHODS: Using the keywords "dopamine D₂ receptor occupancy," "schizophrenia," "PET/SPECT" and "antipsychotics," and further refining our search to journal articles with information on % striatal D₂ 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 D₂ occupancy was limited to less than 80% in order to control for the appearance of extrapyramidal symptoms, high D₂ 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 D₂ occupancy is a contributing factor for the mechanism of antipsychotic effect in SCZ for some but not all antipsychotic medications.
OBJECTIVE: Treatment of schizophrenia (SCZ) was revolutionized with the development of the antipsychotic medications. Although imaging studies have linked antipsychotic D₂ 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 D₂ receptor occupancy and treatment response in SCZ. METHODS: Using the keywords "dopamine D₂ receptor occupancy," "schizophrenia," "PET/SPECT" and "antipsychotics," and further refining our search to journal articles with information on % striatal D₂ 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 D₂ occupancy was limited to less than 80% in order to control for the appearance of extrapyramidal symptoms, high D₂ 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 D₂ occupancy is a contributing factor for the mechanism of antipsychotic effect in SCZ for some but not all antipsychotic medications.
Authors: Andrew J Roebuck; Wendie N Marks; Max C Liu; Nimra B Tahir; Nadine K Zabder; Terrance P Snutch; John G Howland Journal: Psychopharmacology (Berl) Date: 2018-09-24 Impact factor: 4.530
Authors: Shinichiro Nakajima; Hiroyoshi Takeuchi; Eric Plitman; Gagan Fervaha; Philip Gerretsen; Fernando Caravaggio; Jun Ku Chung; Yusuke Iwata; Gary Remington; Ariel Graff-Guerrero Journal: Schizophr Res Date: 2015-02-13 Impact factor: 4.939
Authors: Danielle Kamis; Lee Stratton; María Calvó; Eduardo Padilla; Néstor Florenzano; Gonzalo Guerrero; Beatriz Molina Rangeon; Juan Molina; Gabriel A de Erausquin Journal: Schizophr Res Date: 2015-02-27 Impact factor: 4.939
Authors: Judith M Gault; John A Thompson; Keeran Maharajh; Patrick Hosokawa; Karen E Stevens; Ann Olincy; Erin I Liedtke; Alex Ojemann; Steven Ojemann; Aviva Abosch Journal: Neuromodulation Date: 2020-02-05
Authors: Mark Abie Horowitz; Sameer Jauhar; Sridhar Natesan; Robin M Murray; David Taylor Journal: Schizophr Bull Date: 2021-07-08 Impact factor: 7.348
Authors: C Bay-Richter; M J O'Callaghan; N Mathur; C M P O'Tuathaigh; D M Heery; K C F Fone; J L Waddington; P M Moran Journal: Neuropsychopharmacology Date: 2013-02-19 Impact factor: 7.853