Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Center, Maastricht, The Netherlands.
J Clin Psychiatry. 2011 Oct;72(10):1397-404. doi: 10.4088/JCP.09m05466yel.
Blockade of dopamine D(2) receptors is thought to mediate the therapeutic effects of antipsychotic medication but may also induce social indifference. As antipsychotic drugs differ in D(2) receptor binding, "tight" and "loose" binding drugs may be hypothesized to differentially affect emotional experience. The present study investigates the differential effects of relatively tight versus looser binding drugs on the experience of emotions in the realm of daily life.
We assessed positive and negative affect in the daily life of 109 patients with a DSM-IV diagnosis of psychotic disorder who were currently taking antipsychotic medication by using the experience sampling method (a structured diary technique). Antipsychotic medication was classified as loose (olanzapine; n = 35) or tight (haloperidol, risperidone; n = 74) binding, based on the drug's dissociation constants at the D(2) receptor. The study was conducted from 2007 to 2008.
Multilevel analyses showed a significant interaction between binding group (loose vs tight) and D(2) receptor occupancy estimates with regard to the experience of positive (P = .008) and negative (P = .019) affect. For tight-binding-agent users, a significant association was found between D(2) receptor binding estimates and both positive affect (P = .040) and negative affect (P = .0001) in the flow of daily life, with increasing levels of estimated D(2) receptor occupancy being associated with decreased feelings of positive affect and increased feelings of negative affect. For loose-binding-agent users, no such association was apparent. These associations were only partly mediated by clinical symptoms.
These findings add ecological validity to previous laboratory findings showing an association between D(2) receptor occupancy and emotional experience.
多巴胺 D2 受体阻断被认为介导了抗精神病药物的治疗效果，但也可能导致社交冷漠。由于抗精神病药物在 D2 受体结合方面存在差异，因此可以假设“紧密”和“宽松”结合的药物会对情绪体验产生不同的影响。本研究调查了相对紧密和宽松结合的药物在日常生活领域对情绪体验的差异影响。
我们使用经验采样法（一种结构化日记技术）评估了 109 名符合 DSM-IV 精神障碍诊断标准的患者在日常生活中的积极和消极情绪。根据药物在 D2 受体上的解离常数，将抗精神病药物分为松散（奥氮平；n=35）或紧密（氟哌啶醇、利培酮；n=74）结合。研究于 2007 年至 2008 年进行。
多层分析显示，结合组（松散与紧密）和 D2 受体占有率估计值与积极（P=0.008）和消极（P=0.019）情绪体验之间存在显著的相互作用。对于紧密结合药物使用者，D2 受体结合估计值与日常生活中的积极情绪（P=0.040）和消极情绪（P=0.0001）之间存在显著关联，随着 D2 受体占有率的增加，积极情绪的感觉降低，消极情绪的感觉增加。对于松散结合药物使用者，没有出现这种关联。这些关联部分由临床症状介导。
这些发现增加了先前实验室研究的生态有效性，表明 D2 受体占有率与情绪体验之间存在关联。
