Chang Wei Hung, Chen Kao Chin, Lee I Hui, Chi Mei Hung, Chen Po See, Yao Wei Jen, Chiu Nan Tsing, Yang Yen Kuang
From the *Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan; †Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin; and ‡Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, §Addiction Research Center, ∥Department of Nuclear Medicine, National Cheng Kung University Hospital, College of Medicine, and ¶Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
J Clin Psychopharmacol. 2017 Feb;37(1):21-26. doi: 10.1097/JCP.0000000000000632.
Dopaminergic dysfunction, namely, dopamine transporter (DAT) availability variations in patients with drug-naive schizophrenia after long-term treatment, is still not well understood. The aims of the study were to explore (i) whether the DAT availability in patients with drug-naive schizophrenia differed after antipsychotic treatment and (ii) whether treatment with different generations of antipsychotics influenced the DAT availability after follow-up for 6 months.
Twenty-four first-episode, drug-naive patients with schizophrenia were divided into first- and second-generation antipsychotic groups naturalistically. After 6 months of follow-up, 7 patients who received first-generation antipsychotic treatment and 17 patients who received second-generation antipsychotic treatment completed the study. The patients underwent premedication and 6-month follow-up measurements using single-photon emission computed tomography with technetium Tc 99m (Tc) TRODAT-1. Psychopathological evaluations and adverse effects were recorded using appropriate scales.
Both of the treatment groups significantly improved according to Positive and Negative Symptoms Scale evaluation. However, no significant difference was noticed between the premedication and 6-month follow-up DAT scans. Nonsignificant differences existed even in the groups of different generations of antipsychotics.
Improvements in psychotic symptoms in patients with schizophrenia may not be influenced by DAT availability, even under treatment with different antipsychotics for a sufficient treatment period.
多巴胺能功能障碍，即长期治疗后初发未用药精神分裂症患者多巴胺转运体（DAT）可用性的变化，目前仍未完全明确。本研究旨在探讨：（i）初发未用药精神分裂症患者在接受抗精神病药物治疗后DAT可用性是否存在差异；（ii）使用不同代抗精神病药物治疗6个月后是否会影响DAT可用性。
24例首发、初发未用药的精神分裂症患者按自然状态分为第一代和第二代抗精神病药物治疗组。随访6个月后，7例接受第一代抗精神病药物治疗的患者和17例接受第二代抗精神病药物治疗的患者完成了研究。患者在用药前和随访6个月时使用锝Tc 99m（Tc）TRODAT-1单光子发射计算机断层扫描进行测量。使用适当的量表记录精神病理学评估和不良反应。
根据阳性和阴性症状量表评估，两个治疗组均有显著改善。然而，用药前和随访6个月时的DAT扫描结果无显著差异。不同代抗精神病药物治疗组之间也无显著差异。
即使在使用不同抗精神病药物进行充分治疗的情况下，精神分裂症患者精神病症状的改善可能不受DAT可用性的影响。
