Wolkin A, Barouche F, Wolf A P, Rotrosen J, Fowler J S, Shiue C Y, Cooper T B, Brodie J D
Psychiatry Service, New York VA Medical Center, NY 10010.
Am J Psychiatry. 1989 Jul;146(7):905-8. doi: 10.1176/ajp.146.7.905.
Because CNS neuroleptic concentration cannot be directly measured in patients, the relation between clinical response and extent of dopamine receptor blockade is unknown. This relationship is critical in ascertaining whether nonresponse to neuroleptics is the result merely of inadequate CNS drug levels or of more basic biological differences in pathophysiology. Using [18F]N-methylspiroperidol and positron emission tomography, the authors assessed dopamine receptor occupancy in 10 schizophrenic patients before and after treatment with haloperidol. Responders and nonresponders had virtually identical indices of [18F]N-methylspiroperidol uptake after treatment, indicating that failure to respond clinically was not a function of neuroleptic uptake or binding in the CNS.
由于无法直接测量患者中枢神经系统（CNS）中的抗精神病药物浓度，因此临床反应与多巴胺受体阻断程度之间的关系尚不清楚。这种关系对于确定抗精神病药物治疗无反应仅仅是由于中枢神经系统药物水平不足还是由于病理生理学中更基本的生物学差异至关重要。作者使用[18F]N-甲基螺哌啶醇和正电子发射断层扫描技术，评估了10例精神分裂症患者在使用氟哌啶醇治疗前后的多巴胺受体占有率。治疗后，有反应者和无反应者的[18F]N-甲基螺哌啶醇摄取指标几乎相同，这表明临床无反应并非中枢神经系统中抗精神病药物摄取或结合的作用。
