Work

Antipsychotic dopamine D2 affinity and negative symptoms in remitted first episode psychosis patients

Year: 2024

Type: article

Abstract: Negative symptoms can be an integral part of schizophrenia spectrum pathology and can be secondary to other psychotic symptoms or caused by antipsychotic medication. As antipsychotic drugs differ in their affinity to dopamine receptors and some antipsychotics have partial agonistic effects, antipsychotic drugs are expected to vary in their ability to cause negative symptoms. The association between negative symptoms and antipsychotic medication divided into partial agonists, or antagonists with high or low D 2 affinity was assessed in 310 remitted first episode psychosis (FEP) patients. Severity of negative symptoms was assessed with the Comprehensive Assessment of Symptoms and History, and the Positive and Negative Syndrome Scale. Linear regression analyses were performed while controlling for differences in clinical and sociodemographic characteristics between the groups using inverse probability of treatment weighting. Patients using partial agonists ( n = 78) showed fewer negative symptoms compared to those using high affinity antagonists ( n = 84). Patients using partial agonists displayed less severe negative symptoms compared to those using low affinity antagonists ( n = 148) at a trend level ( p = 0.051). Negative symptom severity was higher in patients who had higher antipsychotic doses. In remitted FEP patients, we observed that the use of antipsychotic medication classified as partial agonists was associated with lower severity of negative symptoms, while the use of antagonists with high D 2 affinity was associated with more severe negative symptoms. • In remitted FEP patients, persistence of negative symptoms reduces quality of life and social and vocational recovery. • FEP patients using antipsychotics with partial D2R agonism showed less severe negative symptoms than high affinity antagonists. • There was a trend that FEP patients on partial agonists had milder negative symptoms than those on low affinity antagonists • Aripiprazole treatment was related to less severe negative symptoms, a potentially important advantage for recovery.

Source: Schizophrenia Research

DOI: 10.1016/j.schres.2024.09.030