| Title: |
Dopamine D2/3R availability after discontinuation of antipsychotic treatment: a [11C]raclopride PET study in remitted first-episode psychosis patients |
| Authors: |
de Beer,Franciska; de Vries,Erik; Wijnen,Ben; Begemann, Marieke J H; van Beveren,Nico; Boonstra, Nynke; Gangadin,Shiral S; de Haan,Lieuwe; Hamers,Iris M H; Veling,Wim; Koops,Sanne; Sommer, Iris E C; Hersenen-Medisch 1 |
| Publication Year: |
2025 |
| Subject Terms: |
Adult; Antipsychotic Agents/therapeutic use; Case-Control Studies; Corpus Striatum/metabolism; Dopamine D2 Receptor Antagonists; Female; Humans; Male; Positron-Emission Tomography; Psychotic Disorders/drug therapy; Raclopride; Receptors; Dopamine D2/metabolism; Dopamine D3/metabolism; Recurrence; Young Adult; Journal Article |
| Description: |
BACKGROUND: After remission of a first-episode psychosis (FEP), antipsychotic discontinuation is associated with an increased risk of relapse compared to maintenance treatment. We studied short and longer-term effects of discontinuation of D 2 receptor (D 2R) antagonist and partial agonist antipsychotics on striatal dopamine D 2/3R availability in FEP patients. METHODS: Remitted FEP patients underwent two [ 11C]raclopride PET scans to measure striatal D 2/3R availability: 1 week after antipsychotic discontinuation (n = 16 antagonist users, n = 6 partial agonist users) and after being medication free for 6-8 weeks (n = 8 antagonist users, n = 5 partial agonist users). Fifteen matched healthy controls were scanned once. Psychotic relapse was monitored up to 12 months after discontinuation. RESULTS: One week after discontinuation, D 2R antagonist discontinuers showed higher striatal binding potential (BP ND) than partial D 2R agonist discontinuers ( p < 0.001, CI=0.749 to 1.681) and controls ( p=0.045, CI=0.008 to 0.708), while partial agonist discontinuers had significantly lower BP ND than controls ( p=0.001, CI=-1.326 to -0.386). 6-8 weeks after discontinuation, former antagonist users showed similar BP ND to controls ( p > 0.25), whereas former partial agonist users had higher BP ND than controls ( p = 0.027, CI = 0.069 to 1.085). Participants who discontinued antagonists relapsed more often (81%) than those who discontinued partial agonists (17%)(χ 2 = 5.32, p = 0.021). CONCLUSIONS: Discontinuation of partial D 2R agonists may affect D 2/3R availability differently than discontinuation of antagonists, which might explain the greater relapse risk after tapering antagonists than partial agonist antipsychotics. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
0033-2917 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/467645 |
| Availability: |
https://dspace.library.uu.nl/handle/1874/467645 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.3B55EC42 |
| Database: |
BASE |