Subjective experience and dopamine D2 receptor occupancy in patients treated with antipsychotics: clinical implications.
OBJECTIVE
This paper gives an overview of studies on the association between dopaminergic neurotransmission and the subjective experience of patients with schizophrenia.


METHODS
We undertook a review of the literature.


RESULTS
Dopaminergic neurotransmission may be relevant for subjective experience. Higher striatal D2 receptor occupancy by typical and atypical antipsychotics is related to worse subjective experience, more severe negative symptoms, and depression. Individuals with lower baseline dopamine function are at an increased risk for dysphoric responses during antipsychotic therapy with dopaminergic-blocking drugs. There is preliminary evidence that a window of striatal D2 receptor occupancy between 60% and 70% is optimal for the subjective experience of patients. These occupancies are often reached even with low dosages of antipsychotic drugs.


CONCLUSIONS
Reaching an optimal dopamine D2 receptor occupancy is clinically relevant, since subjective experience associated with antipsychotic medication is related to medication compliance. Antipsychotic drug dosages often need to be lower than levels in common use.
de Haan
Lieuwe
L
Adolescent Clinic, Academic Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands. l.dehaan@amc.uva.nl
Lavalaye
Jules
J
van Bruggen
Marion
M
van Nimwegen
Lonneke
L
Booij
Jan
J
van Amelsvoort
Therese
T
Linszen
Don
D
D014150:Antipsychotic Agents / Q000145:classification / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D001523:Mental Disorders / Q000145:classification / Q000188:drug therapy* / Q000378:metabolism*; D017448:Receptors, Dopamine D2 / Q000187:drug effects* / Q000378:metabolism*
D014150:Antipsychotic Agents; D017448:Receptors, Dopamine D2