Comparing dopamine D2 receptor occupancies for use in clinical practice: Attractive proposition but fraught with pitfalls

摘要

We refer to the recently published meta-analysis entitled "Estimating Dopamine D2 Receptor Occupancy for Doses of 8 Antipsychotics: A Meta-Analysis" by Lako et al.1 As the title suggests, this review examined the D2 receptor occupancies of haloperidol, risperidone, olanzapine, cloza-pine, quetiapine, aripiprazole, ziprasidone, and amisulpride.Elucidating a valid measure to compare antipsychotic doses is an important but challenging endeavor. Currently, 2 strategies exist for the purpose of comparing antipsychotic doses, which are as follows: the consensus method based on prescription practices of polled experts and the calculation methods based on dose equivalence of empirically defined clinically effective doses. The limitations of these approaches have been highlighted in a recent review.5 Lako et al1 adopted a D2 receptor occupancy approach to compare 8 antipsychotics, concluding that the functions derived from the meta-analysis can be used to compare antipsychotic effects in research studies and clinical practice.