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Title: Dopamine D2/3 occupancy of ziprasidone across a day : a within-subject PET study
Authors: Suzuki, Takefumi
Graff-Guerrero, Ariel
Uchida, Hiroyuki
Remington, Gary
Caravaggio, Fernando
Borlido, Carol
Pollock, Bruce G.
Mulsant, Benoit H.
Deluca, Vincenzo
Ismail, Zahinoor
Mamo, David
Keywords: Receptors, Dopamine
Tomography, Emission
Issue Date: 2013
Publisher: Springer
Citation: Suzuki, T., Graff-Guerrero, A., Uchida, H., Remington, G., Caravaggio, F., Borlido, C., ... & Mamo, D. (2013). Dopamine D2/3 occupancy of ziprasidone across a day: a within-subject PET study. Psychopharmacology, 228(1), 43-51.
Abstract: Rationale Ziprasidone is an atypical antipsychotic recommended to be administered twice daily. Objectives The purpose of this study was to investigate whether occupancy of the dopamine D2/3 receptors by ziprasidone is maintained across a day employing a within subject design. Methods Positron emission tomography (PET) scans with [11C]-raclopride were performed in 12 patients with schizophrenia while treated with ziprasidone 60 mg twice daily. Each patient completed [11C]-raclopride PET scans at 5, 13 and 23 h after the last dose of ziprasidone. Dopamine D2/3 receptor occupancy was estimated with reference to binding potential data of 44 age- and sex-matched control subjects in the caudate, putamen and ventral striatum. Results Eleven scans were available at each time point, and the mean occupancies at 5-, 13- and 23-h scans were 66, 39 and 2 % in the putamen; 62, 35 and −6 % in the caudate; and 68, 47 and 11 % in the ventral striatum, respectively. The time-course of receptor occupancy across the regions indicated an occupancy half-life of 8.3 h. The serum level of ziprasidone associated with 50 % D2/3 receptors occupancy was estimated to be 204 nmol/L (84 ng/ml). Prolactin levels were highest at 5-h post-dose and none showed hyperprolactinemia at 23-h scans. Conclusions The absence of ziprasidone striatal D2/3 receptor binding 23 h after taking 60 mg under steady-state conditions is consistent with its peripheral half-life. The results support our earlier report that ziprasidone 60 mg administered twice daily appears to be the minimal dose expected to achieve therapeutic central dopamine D2/3 receptor occupancy (i.e. 60 %).
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