title: Altered emotional experiences attributed to antipsychotic medications - A potential link with estimated dopamine D2 receptor occupancy.
abstract: Altered emotional experiences in response to antipsychotics may increase the burden of disease in patients with schizophrenia. In a large cross-sectional study, patients with schizophrenia completed the Subjects Reaction to Antipsychotics questionnaire (SRA) to assess whether they attributed altered emotional experiences (flattened affect or depressive symptoms) to their antipsychotics. Association with antipsychotic D2 receptor affinity and occupancy was examined using logistic regression. We compared antipsychotic-attributed emotional experiences between patients using antipsychotic monotherapy and combination therapy. Of the 1298 included patients, 23% attributed flattened affect to their antipsychotics and 16% attributed depressive symptoms to their antipsychotics, based on the SRA. No differences were observed between antipsychotics in patients on monotherapy. We discuss that within these patients' relatively low dose range, altered emotional experiences did not appear to relate to the level of D2 receptor affinity of antipsychotic monotherapy. Patients using antipsychotic combination therapy (22%) were more likely to attribute depressive symptoms to their antipsychotics than patients using antipsychotic monotherapy (OR [95%CI]=1.443 [1.033-2.015]); possibly due to higher D2 receptor occupancies as estimated by dose equivalents.
authors.affiliation: Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands.
authors.forename: Irene M
authors.initials: IM
authors.lastname: Lako
authors.affiliation: Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands. Electronic address: k.taxis@rug.nl.
authors.forename: Katja
authors.initials: K
authors.lastname: Taxis
authors.affiliation: Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: Edwin R
authors.initials: ER
authors.lastname: van den Heuvel
authors.affiliation: Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands; Central Animal laboratory, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Cathalijn H C
authors.initials: CHC
authors.lastname: Leenaars
authors.affiliation: Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Huibert
authors.initials: H
authors.lastname: Burger
authors.affiliation: Rob Giel Research center, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Durk
authors.initials: D
authors.lastname: Wiersma
authors.affiliation: Department of Psychotic Disorders, Mental Health Organization Drenthe, The Netherlands.
authors.forename: Cees J
authors.initials: CJ
authors.lastname: Slooff
authors.affiliation: Rob Giel Research center, University Medical Center Groningen, Groningen, The Netherlands; Lentis Research, Center for Mental Health Groningen, Groningen, The Netherlands.
authors.forename: Henderikus
authors.initials: H
authors.lastname: Knegtering
authors.affiliation: Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands; Rob Giel Research center, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Richard
authors.initials: R
authors.lastname: Bruggeman
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D014150:Antipsychotic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D018492:Dopamine Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D004644:Emotions / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D018492:Dopamine Antagonists
keywords: Antipsychotic; D(2) receptor; Depressive symptoms; Flattened affect; Schizophrenia; Side effects