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携带DRD2*A1等位基因的精神分裂症患者在抗精神病药物治疗中的催乳素水平。

Prolactin levels in antipsychotic treatment of patients with schizophrenia carrying the DRD2*A1 allele.

作者信息

Young Ross McD, Lawford Bruce R, Barnes Mark, Burton Simon C, Ritchie Terry, Ward Warren K, Noble Ernest P

机构信息

Alcohol Research Center, Neuropsychiatric Institute, University of California, Los Angeles, CA 90024-1759, USA.

出版信息

Br J Psychiatry. 2004 Aug;185:147-51. doi: 10.1192/bjp.185.2.147.

Abstract

BACKGROUND

Hyperprolactinaemia induced by D(2) dopamine receptor antagonist antipsychotic medication can result in significant health problems.

AIMS

To examine the role of DRD2 polymorphism on prolactin levels in patients treated with antipsychotic medication.

METHOD

Antipsychotic drugs with different degrees of D(2) receptor binding were given to 144 patients with schizophrenia. Serum prolactin levels were obtained and Taq1A DRD2 alleles were determined.

RESULTS

Prolactin levels increased across medication groups reflecting increasingly tight D(2) receptor binding (clozapine, olanzapine, typical antipsychotics and risperidone). In the combined medication group, patients with the DRD2()A1allele had 40% higher prolactin levels than patients without this allele. In patients treated with clozapine (the loosest D(2) receptor binding agent), patients with the DRD2()A1allele had prolactin levels twice those of patients without this allele.

CONCLUSIONS

Patients with the DRD2A1 allele receiving antipsychotic medications had higher prolactin levels and were overrepresented among those with hyperprolactinaemia, suggesting greater functional D(2) receptor binding in this group.

摘要

背景

D2多巴胺受体拮抗剂抗精神病药物引起的高催乳素血症可导致严重的健康问题。

目的

研究DRD2基因多态性在接受抗精神病药物治疗患者的催乳素水平中的作用。

方法

对144例精神分裂症患者给予不同程度D2受体结合的抗精神病药物。测定血清催乳素水平并确定Taq1A DRD2等位基因。

结果

各药物治疗组的催乳素水平均升高,反映出D2受体结合越来越紧密(氯氮平、奥氮平、典型抗精神病药物和利培酮)。在联合用药组中,携带DRD2()A1等位基因的患者催乳素水平比未携带该等位基因的患者高40%。在接受氯氮平治疗的患者中(D2受体结合最不紧密的药物),携带DRD2()A1等位基因的患者催乳素水平是未携带该等位基因患者的两倍。

结论

携带DRD2 A1等位基因的患者接受抗精神病药物治疗后催乳素水平较高,且在高催乳素血症患者中占比过高,提示该组患者的D2受体结合功能更强。

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