PET Measurements of Neuroreceptor Occupancy by Typical and Atypical Neuroleptics
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Sokoloff L, Reivich M, Kennedy C, et al. The [‘4C]deoxyglucosemethod for the Flow Metab l981;l:39I—40l. PET Measurements of Neuroreceptor Occupancy by Typical and Atypical Neuroleptics Peter F. Goyer, Marc S. Berridge, Evan D. Morris, William E. Semple, Beth A. Compton-Toth, S. Charles Schulz, Dean F. Wong, Floro Miraldi and Herbert Y. Meltzer Cleveland Veterans Affairs Medical Center, Cleveland, Ohio; Departments ofRadiology and Psychiatry, Case Western Reserve University Medical School and University Hospitals, Cleveland, Ohio; and Department of Radiology, Johns Hopkins University Medical School, Baltimore, Maryland subjects who were b@ngtreated with ckzapine, an atypk@alanlipsy The goal of this study was to use PET and 11C-N-methylspiperone chotic drug. ResuI@ Among the three groups, there were significant (11C-NMSP)to measurethe differencesin relativeoccupancyof differences in5-HT@ indices, D2 indk@esand the ratio of 5-HT@to D2 serotonin (5-hydroxytryptamine-2 or 5-HT@) and dopamine-2 (D2) indices. With no overlap, the 5-HT@,index separated allsubjects who neuroreceptors in subjects being treated with typical or atypical recsived clozapne and the D2 index separated the remaining two antipsychotic drugs. Methods: We used PET and single-dose groups. Conclusion: Typkal antipsychotk@and atypical antipsychotic 11C-NMSP to measure receptor indices and relative receptor occu subjects do have differingpatterns of 5-HT@ and D2 relative receptor pancy of 5-HT2Areceptors in frontal cortex and D2 receptors in occupancy when measured with a single PE@scan, single 11C-NMSP basal ganglia infive subjects who were neuroleptic free, fivesubjects who were being treated with typical antipsychotic drugs and five radiotracer dose and no separately injected “cold―pharmaceutical. Key Words PET; carbon-i 1-N-methylspiperone; neuroreceptor cc cupancy ReceivedMar.24, 1995;revisionaccepted Nov.1, 1995. Forcorrespondenceorreprintscontact:PeterF.Goyer,MD,chiefofstaff,cleveland J NucIMed1996;37:1122—1127 vAMc(B).10,000BreCkSVIlieRd.,Brecksville,OH44141. 1122 THEJOURNALOFNUCLEARMEDICINE•Vol. 37 •No. 7 •July 1996 InvitroN-methylspiperone(NMSP)hasbeencharacterizedas 5-HT2Areceptorsandlow occupancyof D2receptors,whilethe a high affinity dopamine-2 (D2) receptor ligand in rat and reverse is true of typical antipsychotic drugs. Meltzer (18,19) human caudate (1 ) as well as a serotonin-2 (5-hydroxytrypta suggested that the superior efficacy and low extrapyramidal mine-2 or 5-HT2A) receptor ligand in rat and human frontal side effects of clozapine may be related not to absolute receptor cortex (1 ). NMSP has been characterized in vivo as a D2 and occupancy ofthe individual 5-HT2A and D2 receptors but to the 5-HT2Aligand in mice (2), baboons(3,4) andhumans(5,6). [In extent of 5-HT2A receptor occupancy relative to D2 receptor accordance with the Serotonin Receptor Nomenclature Com occupancy. mittee (7), 5-HT2A will be the notation used for receptors This study was designed to use ‘‘C-NMSP as a single previously denoted as 5-HT2.] radiotracer to examine relative receptor occupancy produced by In 1983, Wagner et al. (5) reported the use of ‘1C-NMSP clozapine and by typical antipsychotic drugs of 5-HT2A recep with PET to image D2 receptors in human basal ganglia. tors in frontal cortex and of D2 receptors in basal ganglia to test Subsequently, Wong et al.