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Eficacia de los antipsicóticos: relación con la ocupación óptima de los receptores D2

Published online by Cambridge University Press:  12 May 2020

Luca Pani
Affiliation:
PharmaNess S.c.a.r.l., Parque Tecnológico-Investigación Sardegna, Pula (CA), Italia CNR, Instituto de Tecnología Biomédica. Cagliari, Parque Tecnológico - Investigación Sardegna, Pula (CA), Italia
Luigi Pira
Affiliation:
PharmaNess S.c.a.r.l., Parque Tecnológico-Investigación Sardegna, Pula (CA), Italia
Giorgio Marchese
Affiliation:
PharmaNess S.c.a.r.l., Parque Tecnológico-Investigación Sardegna, Pula (CA), Italia
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Resumen

Hay diferencias clínicamente importantes en la seguridad y tolerabilidad de los antipsicóticos dependiendo de los distintos tipos y de sus formulaciones. Las características de la interacción bioquímica entre el antipsicótico y el receptor D2 pueden ser la base de estas diferencias. Este artículo revisa la información actual sobre la relación entre la ocupación del antipsicótico por el receptor y la respuesta clínica. Se hizo una búsqueda en la literatura introduciendo las palabras clave “antipsicótico o neuroléptico”, “receptor”, “ocupación”, “dopamina” y “D2” y se complementó con búsquedas manuales en la literatura. Los datos de las pruebas de neuroimagen y clínicas, generalmente, confirmaron que la ocupación óptima de los receptores D2 del núcleo estriado se sitúa en “una ventana térapeutica” entre ∼ 65% y ∼ 80%; sin embargo, las propiedades farmacocinéticas y farmacodinámicas del fármaco también deberían tenerse en cuenta para evaluar totalmente sus efectos terapéuticos. Deberían realizarse nuevas investigaciones, quizá, en modelos preclínicos, para deetrminar la ocupación de los receptores D2 en varias regiones cerebrales y la duración óptima del bloqueo de los receptores D2 para maximizar los perfiles de eficacia y tolerabilidad de los antipsicóticos atípicos y mejorar los resultados del tratamiento de los pacientes con esquizofrenia.

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Revisión
Copyright
Copyright © European Psychiatric Association 2007

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References

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