Dopamine blockade and clinical response: evidence for two biological subgroups of schizophrenia.
Because CNS neuroleptic concentration cannot be directly measured in patients, the relation between clinical response and extent of dopamine receptor blockade is unknown. This relationship is critical in ascertaining whether nonresponse to neuroleptics is the result merely of inadequate CNS drug levels or of more basic biological differences in pathophysiology. Using [18F]N-methylspiroperidol and positron emission tomography, the authors assessed dopamine receptor occupancy in 10 schizophrenic patients before and after treatment with haloperidol. Responders and nonresponders had virtually identical indices of [18F]N-methylspiroperidol uptake after treatment, indicating that failure to respond clinically was not a function of neuroleptic uptake or binding in the CNS.
Wolkin
A
A
Psychiatry Service, New York VA Medical Center, NY 10010.
Barouche
F
F
Wolf
A P
AP
Rotrosen
J
J
Fowler
J S
JS
Shiue
C Y
CY
Cooper
T B
TB
Brodie
J D
JD
D000293:Adolescent; D000328:Adult; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000378:metabolism; D003342:Corpus Striatum / Q000000981:diagnostic imaging / Q000378:metabolism; D015259:Dopamine Agents; D018492:Dopamine Antagonists; D005462:Fluorine Radioisotopes; D006220:Haloperidol / Q000097:blood / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011954:Receptors, Dopamine / Q000187:drug effects* / Q000378:metabolism; D012559:Schizophrenia / Q000378:metabolism / Q000503:physiopathology*; D013134:Spiperone / Q000031:analogs & derivatives; D014055:Tomography, Emission-Computed
D015259:Dopamine Agents; D018492:Dopamine Antagonists; D005462:Fluorine Radioisotopes; D011954:Receptors, Dopamine; D013134:Spiperone; C039167:3-N-methylspiperone; D006220:Haloperidol