Antipsychotic Medications: Linking Receptor Antagonism to Neuropsychological Functioning in First Episode Psychosis
Antipsychotic Medications: Linking Receptor Antagonism to Neuropsychological Functioning in First Episode Psychosis
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DOI：
10.1017/s1355617712000343
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发表时间：
2012-07-01
影响因子：
2.6
通讯作者：
Honer, William G.
中科院分区：
文献类型：
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作者：
Baitz, Heather A.;Thornton, Allen E.;Honer, William G.
抗精神病药物可导致神经认知和运动障碍，但与个体化药物治疗方案的具体联系尚不清楚。在68名稳定首发精神病（FEP）的参与者中，我们研究了神经心理功能与建立的抗胆碱能效价指数和我们实验室开发的新的D，拮抗剂效价指数之间的联系。根据特定的药物剂量，将每个参与者的精神药物治疗方案转化为估计的受体拮抗剂负荷，并报告体外脑毒蕈碱胆碱能和ID受体拮抗剂。除了FEP参与者的整体神经心理障碍外，研究结果还支持了受体拮抗剂负荷与特异性缺陷之间的假设联系。较高的抗胆碱能负荷与较差的延迟言语记忆有关，但与运动功能无关。相反，较高的D负荷与较差的运动功能有关，但与言语记忆无关。这些选择性拮抗剂负荷关联解释了19%的运动功能差异和17%的延迟言语记忆差异。显然，在FEP患者中发现的一些神经心理障碍与特定的药效学和药物治疗方案的剂量有选择性的关系。此外，这些影响可以很容易地从实用和廉价的指数估计。（植物学报，2012,18,717-727）
Antipsychotic medications can contribute to neurocognitive and motor impairments, but specific links to individualized pharmacological treatment regimens are unclear. In 68 participants with stabilized first-episode psychosis (FEP), we investigated the links between neuropsychological functions and an established anticholinergic potency index and a new D, antagonist potency index developed in our lab. Each participant's psychiatric medication regimen was converted into estimated receptor antagonist loads based upon specific medication dosage(s) and reported in vitro brain muscarinic cholinergic and ID, receptor antagonism. In addition to the global neuropsychological impairments of FEP participants, the findings supported the hypothesized links between receptor antagonist loads and specific deficits. Higher anticholinergic load was associated with poorer delayed verbal memory but was not related to motor functioning. In contrast, higher D, load was associated with poorer motor functioning but not verbal memory. These selective antagonist load associations explained 19% of the variance in motor functioning and 17% of the variance in delayed verbal memory. Evidently, some of the neuropsychological impairments found in persons with FEP are selectively related to the specific pharmacodynamics and the dosing of their medication regimens. Moreover, these effects can be readily estimated from practical and inexpensive indices. (JINS, 2012, 18, 717-727)