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Dopamine and Response to Antipsychotic Medication

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PET and SPECT in Psychiatry

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Abstract

The precise molecular basis of schizophrenia is not completely understood. In this chapter, we will describe and examine the evidence from PET and SPECT imaging findings on the key role that dopamine, the neurotransmitter most strongly associated with schizophrenia, plays in its pathophysiology. We will review the evidence for presynaptic dopamine pathway dysfunction, which is most apparent in the associative striatum and involves abnormal elevations of dopamine synthetic capacity, dopamine release and synaptic dopamine levels. This dysfunction is well correlated with the increased likelihood, onset and worsening severity of schizophrenia. Furthermore, this association appears to be crucial in relation to the therapeutic response to dopamine antagonists.

Here, in addition we review the evidence for the mechanism of action of current antipsychotics, by examining the roles that pre- and postsynaptic dopamine modulation play in their clinical efficacy. Furthermore treatment resistance, current understanding about its neurological underpinnings and treatment strategies will be outlined. Finally, we explore the dopamine and non-dopaminergic mechanisms of potential novel therapies.

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Authors and Affiliations

  1. South London and Maudsley NHS Foundation Trust, London, UK

    Chukwuma U. Ntephe & Arsime Demjaha

  2. Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK

    Arsime Demjaha

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Correspondence to Chukwuma U. Ntephe .

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  1. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Rudi A.J.O. Dierckx

  2. Faculty of Electrical Engineering, Medical Engineering and Computer Science, Offenburg University, Offenburg, Germany

    Andreas Otte

  3. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Erik F. J. de Vries

  4. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Aren van Waarde

  5. Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, The Netherlands

    Iris E. Sommer

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Ntephe, C.U., Demjaha, A. (2021). Dopamine and Response to Antipsychotic Medication. In: Dierckx, R.A., Otte, A., de Vries, E.F.J., van Waarde, A., Sommer, I.E. (eds) PET and SPECT in Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-57231-0_14

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