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Prediction and assessment of extrapyramidal side effects induced by risperidone based on dopamine D 2 receptor occupancy
Author(s) -
Yamada Yasuhiko,
Ohno Yoshiyuki,
Nakashima Yoshifumi,
Fukuda Masato,
Takayanagi Risa,
Sato Hitoshi,
Tsuchiya Fumito,
Sawada Yasufumi,
Iga Tatsuji
Publication year - 2002
Publication title -
synapse
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.809
H-Index - 106
eISSN - 1098-2396
pISSN - 0887-4476
DOI - 10.1002/syn.10111
Subject(s) - extrapyramidal symptoms , risperidone , pharmacology , dopamine receptor d2 , medicine , chemistry , dopamine , antipsychotic , schizophrenia (object oriented programming) , psychiatry
In the present study, we attempted to predict the risk of extrapyramidal side effects of a selective monoaminergic antagonist, risperidone, by analyzing the correlation between the dopamine D 2 receptor occupancy and the degree of extrapyramidal side effects of the drug. The occupancies of D 2 and 5‐HT 2 receptors at various doses of risperidone were calculated by means of a receptor occupancy theory. The extrapyramidal side effects after administration of risperidone were attempted to predict by theoretical analysis of the correlation between the calculated occupancies and the evidence of extrapyramidal symptoms using a ternary complex model. The pharmacokinetic/pharmacodynamic analysis utilized the data concerning the pharmacokinetics of risperidone and 9‐hydroxyrisperidone (active metabolite), their binding affinities with D 2 and 5‐HT 2 receptors, and the clinical evidence of extrapyramidal symptoms (Extrapyramidal Symptom Rating Scale: ESRS), gathered from the literature. The mean occupancy of 5‐HT 2 receptors after the administration of regular doses of risperidone was suggested to be more than 90%, whereas the mean occupancy of D 2 receptors varied between 50–80%, depending on the dose. The correlation between the occupancy of D 2 receptors and the extrapyramidal symptoms could be successfully analyzed with a ternary complex model, showing the predictability of the model for the extrapyramidal side effects of risperidone. Since the estimated risk of the extrapyramidal side effects varied with the dose, the present method of predicting the extrapyramidal side effects of risperidone may provide a basis for developing a rational dosing regimen for the drug. Synapse 46:32–37, 2002. © 2002 Wiley‐Liss, Inc.