D2 and D3 dopamine receptor affinity predicts effectiveness of antipsychotic drugs in obsessive-compulsive disorders: a metaregression analysis.

RATIONALE AND OBJECTIVE

The relationship between clinically effective antipsychotic drugs in obsessive-compulsive disorders (OCD) and binding affinities to cloned dopamine and serotonin receptor subtypes was analyzed in an effort to clarify the contribution of individual receptor subtypes to medication response.

METHODS

Meta-analysis was used to update previous meta-analyses of effectiveness data of add-on antipsychotic drugs to selective serotonin reuptake inhibitors (SSRIs) in OCD. Twelve previously analyzed randomized controlled trials (RCTs) and one new RCT were included. We performed a metaregression using a mixed-effect model to examine the association between antipsychotic's effectiveness and receptor affinity.

RESULTS

A total of 5 treatment arms obtained from 13 RCTs (431 patients) were included in our study. The results of our metaregression showed a significant association between D2 and D3 dopamine receptor affinities and effectiveness in OCD (respectively, slope = -0.36, p = 0.01; and slope = -0.50, p = 0.01) whereas other dopamine receptors and serotonin receptors were not significantly associated.

CONCLUSIONS

These observations suggest that increasing D2 and D3 dopamine receptor binding affinities enhances antipsychotics' effectiveness in obsessive-compulsive disorders.