Pilowsky L S, Busatto G F, Taylor M, Costa D C, Sharma T, Sigmundsson T, Ell P J, Nohria V, Kerwin R W
Institute of Psychiatry, London, UK.
Psychopharmacology (Berl). 1996 Mar;124(1-2):148-53. doi: 10.1007/BF02245615.
We have studied striatal D2 dopamine binding in schizophrenic patients treated with the novel atypical antipsychotic drug, olanzapine. 123I iodobenzamide (IBZM) single photon emission tomography (SPET) was used to estimate striatal dopamine D2 receptor binding in vivo. Patients were recruited from a prospective, double blind controlled trial of olanzapine versus haloperidol treatment. In vivo striatal D2 binding data from olanzapine treated patients (n = 6) were compared with previously reported data from typical antipsychotic responsive (n = 10); clozapine (n = 10); and risperidone (n = 6) treated patient groups. Mean % Brief Psychiatric Rating Scale score (BPRS) improvement following olanzapine treatment was 49% (SD 44). The hypothesis that clinical improvement in olanzapine treated patients would be associated with higher mean striatal D2 binding of 123I IBZM (reflecting lower levels of D2 occupancy) than typical antipsychotic (1.25 +/- 0.05) or risperidone (1.24 +/- 0.04) treatment was confirmed. Olanzapine treated patients had similar levels of striatal D2 binding in vivo (1.41 +/- 0.06) as those treated with clozapine (1.49 +/- 0.04). This preliminary evidence suggests olanzapine is another atypical antipsychotic drug in which therapeutic response is not associated with a high degree of striatal D2 receptor occupancy in vivo.
我们研究了使用新型非典型抗精神病药物奥氮平治疗的精神分裂症患者纹状体D2多巴胺结合情况。采用123I碘苄酰胺（IBZM）单光子发射断层扫描（SPET）来估计体内纹状体多巴胺D2受体结合情况。患者来自一项奥氮平与氟哌啶醇治疗的前瞻性、双盲对照试验。将奥氮平治疗患者（n = 6）的体内纹状体D2结合数据与先前报道的典型抗精神病药物反应者（n = 10）、氯氮平（n = 10）和利培酮（n = 6）治疗患者组的数据进行比较。奥氮平治疗后简明精神病评定量表（BPRS）评分的平均改善率为49%（标准差44）。奥氮平治疗患者的临床改善与123I IBZM的平均纹状体D2结合率较高（反映较低的D2占有率）相关，高于典型抗精神病药物（1.25±0.05）或利培酮（1.24±0.04）治疗，这一假设得到了证实。奥氮平治疗患者的体内纹状体D2结合水平（1.41±0.06）与氯氮平治疗患者（1.49±0.04）相似。这一初步证据表明奥氮平是另一种非典型抗精神病药物，其治疗反应与体内纹状体D2受体的高占有率无关。
