title: The role of striatal dopamine D2 receptors in the occurrence of extrapyramidal side effects: iodine-123-iodobenzamide single photon emission computed tomography study.
abstract: Levels above 75% of striatal dopamine 2 receptor occupancy (D2RO) have been associated with extrapyramidal symptoms (EPS). The aim of the present study is to investigate the relationship between D2RO and EPS in a sample of psychotic patients in current treatment with both typical and atypical antipsychotics. Brain iodine-123-iodobenzamide single photon emission computed tomography ((123)I-IBZM SPECT) was performed in 81 patients taking stable doses of haloperidol, risperidone, olanzapine, quetiapine, clozapine or ziprasidone. First, the degree of D2RO and Positive and Negative Syndrome Scale (PANSS) scores was compared between the group of patients who presented EPS and the group free of EPS. Afterwards, these variables were compared among the different antipsychotic medications. The group with EPS presented means of D2RO significantly higher than the group free of EPS. Significant differences in D2RO were found in clozapine, quetiapine and ziprasidone groups compared with the haloperidol group. No differences were observed between either olanzapine or risperidone and haloperidol. No quetiapine- or clozapine-treated patients developed EPS. Haloperidol and risperidone demonstrated a relationship between striatal D2RO and EPS. The findings suggest that higher D2RO is related to appearance of EPS. Occupancy in the group with EPS was in agreement with previous studies that suggested a high degree of D2RO is necessary for the occurrence of EPS.
authors.affiliation: Department of Psychiatry, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Iluminada
authors.initials: I
authors.lastname: Corripio
authors.forename: Alcides
authors.initials: A
authors.lastname: Ferreira
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Portella
authors.forename: Víctor
authors.initials: V
authors.lastname: Pérez
authors.forename: María J
authors.initials: MJ
authors.lastname: Escartí
authors.forename: Maria
authors.initials: M
authors.lastname: Del Valle Camacho
authors.forename: Rosa B
authors.initials: RB
authors.lastname: Sauras
authors.forename: Anna
authors.initials: A
authors.lastname: Alonso
authors.forename: Eva Ma
authors.initials: EM
authors.lastname: Grasa
authors.forename: Ignasi
authors.initials: I
authors.lastname: Carrió
authors.forename: Ana M
authors.initials: AM
authors.lastname: Catafau
authors.forename: Enric
authors.initials: E
authors.lastname: Alvarez
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001480:Basal Ganglia Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000378:metabolism*; D003342:Corpus Striatum / Q000000981:diagnostic imaging / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism*; D017448:Receptors, Dopamine D2 / Q000378:metabolism*; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D014150:Antipsychotic Agents; D017448:Receptors, Dopamine D2