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Subjective experience and striatal dopamine D2 receptor occupancy in patients with recent-onset schizophrenia treated with olanzapine or risperidone
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Oral Session XIII
between negative subjective experience and high dopamine D z receptor occupancy in patients treated with olanzapine or risperidone.
How is Optimal Dosage to be Determined? SUBJECTIVE E X P E R I E N C E A N D STRIATAL D O P A M I N E D 2 R E C E P T O R O C C U P A N C Y IN PATIENTS WITH R E C E N T - O N S E T S C H I Z O P H R E N I A T R E A T E D WITH O L A N Z A P I N E OR R I S P E R I D O N E
EFFECTS O N C L I N I C A L PSYCHOPATHOLOGY AND FINE MOTOR F U N C T I O N S OF 2 V E R S U S 4 M G R I S P E R I D O N E IN FIRST-EPISODE PSYCHOTIC PATIENTS
L. de H a a n , J. Lavalaye, D. Linszen, P. D i n g e m a n s , J. Booij
M . C . G . Merlo, H. H o f e r , S.R. M a r d e r
Academic. Medical Center. University of Amsterdam, Department of Psychiatry. Post box 22700, 1100 DE Amsterdam, The Netherlands Objective: Evaluation of the relationship between subjective experience during treatment with olanzapine or risperidone, and dopamine D 2 receptor occupancy in stabilized patients with recent onset schizophrenia. Method: After a stable dose period of at least six weeks with olanzapine (n=15, mean dose 14.7mg, SD 5.8rag) or risperidone (n=7, mean dose 4.1 rag, SD 0.9mg), subjective experience was assessed with two self-rating instruments: Subjective Well-being under Neuroleptic treatment (SWN) and the Subjective Deficit Syndrome Scale (SDSS). Within two days of assessment of subjective experience, dopamine D2 receptor occupancy was assessed with 123I-IBZM SPECT. In addition, PANSS, MADRS and extrapyramidal symptoms were independently assessed. Results: Self-control and emotional regulation, as measured with the SWN, were significantly related with dopamine D 2 receptor occupancy. Observer rated depression and negative symptoms also correlated with dopamine D z receptor occupancy. In the subgroup using olanzapine, dose and self-control (as measured with the SWN) and SDSS total score, were related with dopamine D 2 receptor occupancy. Conclusions: A significantly positive relationship was found
Hdpitaux Universitaires de GenOve, Clinique Psychiatrique , Belle-ld~e,. CH-1225 Ch~ne-Bourg/GE The aim of this study was to find differences in improvement of psychopathology and fine motor functions on two doses of risperidone in first-episode psychotic patients. In a controlled double-blind, two-center study, 52 patients who were admitted for the first time and met DSM-IV criteria for schizophrenia, schizophreniform or schizoaffective disorder, were randomly assigned to 2 or 4 mg of risperidone. Treatment efficacy was measured with an expanded version of the BPRS and the SANS, whereas fine motor functions were assessed with a computerized device. Doses of 2 and 4mg of risperidone showed good clinical improvement (e.g. BPRS total score p < 0.01 effect size d = 2.3 resp. 2.17 ). No differences were found in efficacy between the two doses on either positive (e.g. BPRS positive score: F( 1,50)=0.70, p=0.41 ) or negative symptoms scores (SANS total global score: F(1,50)=0.13, p=0.72). Although there were no differences in scores on the Barnes Akathisia Scale and on the Simpson-Angus Scale, computerized fine motor assessment showed less motor side effect in the 2 mg group. In conclusion, both doses of risperidone resulted in similar clinical improvement and the lower dose produced less fine motor dysfunction. These results are consistent with recent positron emission tomography findings indicating that 3mg of risperidone results in < 80°/,, D 2 receptor occupancy (Am J Psychiatry 1999, 156, 869 875).
Oral Session XIII
between negative subjective experience and high dopamine D z receptor occupancy in patients treated with olanzapine or risperidone.
How is Optimal Dosage to be Determined? SUBJECTIVE E X P E R I E N C E A N D STRIATAL D O P A M I N E D 2 R E C E P T O R O C C U P A N C Y IN PATIENTS WITH R E C E N T - O N S E T S C H I Z O P H R E N I A T R E A T E D WITH O L A N Z A P I N E OR R I S P E R I D O N E
EFFECTS O N C L I N I C A L PSYCHOPATHOLOGY AND FINE MOTOR F U N C T I O N S OF 2 V E R S U S 4 M G R I S P E R I D O N E IN FIRST-EPISODE PSYCHOTIC PATIENTS
L. de H a a n , J. Lavalaye, D. Linszen, P. D i n g e m a n s , J. Booij
M . C . G . Merlo, H. H o f e r , S.R. M a r d e r
Academic. Medical Center. University of Amsterdam, Department of Psychiatry. Post box 22700, 1100 DE Amsterdam, The Netherlands Objective: Evaluation of the relationship between subjective experience during treatment with olanzapine or risperidone, and dopamine D 2 receptor occupancy in stabilized patients with recent onset schizophrenia. Method: After a stable dose period of at least six weeks with olanzapine (n=15, mean dose 14.7mg, SD 5.8rag) or risperidone (n=7, mean dose 4.1 rag, SD 0.9mg), subjective experience was assessed with two self-rating instruments: Subjective Well-being under Neuroleptic treatment (SWN) and the Subjective Deficit Syndrome Scale (SDSS). Within two days of assessment of subjective experience, dopamine D2 receptor occupancy was assessed with 123I-IBZM SPECT. In addition, PANSS, MADRS and extrapyramidal symptoms were independently assessed. Results: Self-control and emotional regulation, as measured with the SWN, were significantly related with dopamine D 2 receptor occupancy. Observer rated depression and negative symptoms also correlated with dopamine D z receptor occupancy. In the subgroup using olanzapine, dose and self-control (as measured with the SWN) and SDSS total score, were related with dopamine D 2 receptor occupancy. Conclusions: A significantly positive relationship was found
Hdpitaux Universitaires de GenOve, Clinique Psychiatrique , Belle-ld~e,. CH-1225 Ch~ne-Bourg/GE The aim of this study was to find differences in improvement of psychopathology and fine motor functions on two doses of risperidone in first-episode psychotic patients. In a controlled double-blind, two-center study, 52 patients who were admitted for the first time and met DSM-IV criteria for schizophrenia, schizophreniform or schizoaffective disorder, were randomly assigned to 2 or 4 mg of risperidone. Treatment efficacy was measured with an expanded version of the BPRS and the SANS, whereas fine motor functions were assessed with a computerized device. Doses of 2 and 4mg of risperidone showed good clinical improvement (e.g. BPRS total score p < 0.01 effect size d = 2.3 resp. 2.17 ). No differences were found in efficacy between the two doses on either positive (e.g. BPRS positive score: F( 1,50)=0.70, p=0.41 ) or negative symptoms scores (SANS total global score: F(1,50)=0.13, p=0.72). Although there were no differences in scores on the Barnes Akathisia Scale and on the Simpson-Angus Scale, computerized fine motor assessment showed less motor side effect in the 2 mg group. In conclusion, both doses of risperidone resulted in similar clinical improvement and the lower dose produced less fine motor dysfunction. These results are consistent with recent positron emission tomography findings indicating that 3mg of risperidone results in < 80°/,, D 2 receptor occupancy (Am J Psychiatry 1999, 156, 869 875).