The relationship between subjective well-being and dopamine D2 receptors in patients treated with a dopamine partial agonist and full antagonist antipsychotics

Int J Neuropsychopharmacol. 2009 Jun;12(5):715-21. doi: 10.1017/S1461145709000327. Epub 2009 Apr 15.

Abstract

Antipsychotic drugs produce unpleasant subjective experiences, which have been associated with high levels of dopamine D2 receptor occupancy. Aripiprazole is a partial agonist antipsychotic, which is hypothesized to produce a different subjective experience profile compared to standard D2 antagonist antipsychotics. The aim of this study was to compare the effect of D2 occupancy produced by a partial agonist antipsychotic (aripiprazole) to that of antagonist antipsychotics (risperidone or olanzapine) on the subjective well-being of patients. Subjective well-being was measured using the Subjective Well-being under Neuroleptics Scale (SWN) and was related to dopamine D2 receptor occupancy using [11C]raclopride PET. Patients that were switched to aripiprazole showed improvement in their subjective well-being from 79.80 (S.D.=16.08) to 89.90 (S.D.=15.33), an effect that was sustained for 6 months. This sustained improvement was observed despite very high levels of DA D2 occupancy (82-99%), in contrast to the effects of antagonist antipsychotics on subjective well-being.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affect / drug effects*
  • Affect / physiology
  • Antipsychotic Agents / pharmacology
  • Antipsychotic Agents / therapeutic use*
  • Brain / diagnostic imaging
  • Brain / drug effects
  • Brain / metabolism
  • Dopamine Agonists / pharmacology
  • Dopamine Agonists / therapeutic use*
  • Dopamine Antagonists / pharmacology
  • Dopamine Antagonists / therapeutic use*
  • Dopamine D2 Receptor Antagonists*
  • Humans
  • Positron-Emission Tomography / methods
  • Protein Binding / drug effects
  • Protein Binding / physiology
  • Receptors, Dopamine D2 / agonists*
  • Receptors, Dopamine D2 / metabolism
  • Schizophrenia / drug therapy
  • Schizophrenia / metabolism
  • Young Adult

Substances

  • Antipsychotic Agents
  • Dopamine Agonists
  • Dopamine Antagonists
  • Dopamine D2 Receptor Antagonists
  • Receptors, Dopamine D2