Prediction of clinical response to neuroleptics and positron emission tomography in schizophrenia
Every clinician knows that some schizophrenics show marked improvement in symptoms when treated even with low doses of neuroleptics and others show little improvement or even worsening when medication is given (Carpenter et al. 1981, Brown et al. 1989, Garver et al. 1988). This diversity in treatment response may be especially marked in university research programs where patients who are having their first psychotic episode as well as those who are chronically ill and especially medication resistent may appear. The variation in clinical effects of typical antipsychotic drugs may be explained by the density, affinity, and pharmacological class of receptors with which they interact. Furthermore, individual differences in the pharmacokinetics of antipsychotic drugs, biological heterogeneity in schizophrenia and the particular cerebral regions whose functions are altered directly or indirectly by their administration will play a role on the clinical outcome. Imaging is an insightful pathway into understanding and unraveling some of these variations. The imaging of regional cerebral metabolism can provide information about the initial state of the patient’s brain and the functional consequences of neuroleptic administration throughout the brain.
KeywordsPositron Emission Tomography Metabolic Rate Positron Emission Tomographic Continuous Performance Test Glucose Metabolic Rate
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