Importance: @entity1 with @entity161 ( @entity161 ) are highly susceptible to antipsychotic adverse effects. Treatment guidelines endorse lower antipsychotic doses. However, the optimal dose of antipsychotics and associated @entity935 D2/3 receptor (D2/3R) occupancies remain largely unexplored in @entity1 with @entity161 . Objective: To evaluate effects of antipsychotic dose reduction on striatal @entity935 D2/3R occupancies, clinical variables, and blood pharmacokinetic measures in @entity1 with @entity161 . Design, Setting, and @entity1 : An open-label, single-arm prospective study with a 3- to 6-month follow-up period (January 10, 2007, to October 21, 2013) was conducted at an academic tertiary care center with practice for ambulatory care. @entity1 included 35 outpatients with clinically stable @entity161 ( @entity1 aged >= 50 years receiving @entity1037 or @entity1090 monotherapy at the same dose for 6 to 12 months). Follow-up was completed on October 21, 2013, and analysis was conducted from October 22, 2014, to February 2, 2015. Interventions: @entity505 11-labeled @entity11641 positron emission tomography, clinical measures, and blood pharmacokinetic measures performed before and after gradual dose reduction by up to 40% from the baseline dose and at least 3 months after dose reduction. Main Outcomes and Measures: Striatal @entity935 D2/3R occupancies with antipsychotics, clinical measures (Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale, Targeted Inventory on Problems in @entity161 , Simpson-Angus Scale, Barnes Rating Scale for Drug-Induced @entity2146 , Udvalg for Kliniske Unders  gelser Side Effect Rating Scale), and blood pharmacokinetic measures (prolactin and antipsychotic blood levels). Results: @entity935 D2/3R occupancy of the entire sample decreased by a mean (SD) of 6.2% (8.2%) following dose reduction (from 70%   [12%] to 64%   [12%]; P   <   .001). The lowest D2/3R occupancy associated with clinical stability was 50%. @entity21 ( @entity21 ) were more likely to occur with D2/3R occupancies higher than 60%: 90.5% (19 of 21) of the @entity1 with baseline @entity21 and 76.9% (10 of 13) of the @entity1 with postreduction @entity21 had striatal D2/3R occupancies higher than 60%. The baseline D2/3R occupancies were lower in @entity1 with clinical deterioration (n   =   5) than in those whose condition remained stable (n   =   29) (58% [15%] vs 72% [10%]; P   =   .03). Following dose reduction, Targeted Inventory on Problems in @entity161 score increased (P   =   .046) and Positive and Negative Syndrome Scale (P   =   .02), Brief Psychiatric Rating Scale (P   =   .03), Simpson-Angus Scale (P   <   .001), Barnes Rating Scale for Drug-Induced @entity2146 (P   =   .03), and Udvalg for Kliniske Unders  gelser Side Effect Rating Scale (P   <   .001) scores and prolactin (P   <   .001) and blood antipsychotic ( @entity1037 , P   <   .001; @entity1090 plus the metabolite @entity7302 , P   =   .02) levels all decreased. Conclusions and Relevance: Antipsychotic dose reduction is feasible in @entity1 with stable @entity161 , decreasing adverse effects and improving illness severity measures. The results of the present study suggest a lower therapeutic window of D2/3R occupancy in @entity1 with @entity161 (50%-60%) than previously reported in younger @entity1 (65%-80%).

Evaluation of Antipsychotic Dose Reduction in Late-Life XXXX : A Prospective @entity935 D2/3 Receptor Occupancy Study.

@entity1 :: ('9606', 'Species') :: ['participants', 'Patients', 'patients', 'Participants'] @entity7302 :: ('MESH:C079150', 'Chemical') :: ['9-hydroxyrisperidone'] @entity935 :: ('MESH:D004298', 'Chemical') :: ['dopamine', 'Dopamine'] @entity161 :: ('MESH:D012559', 'Disease') :: ['LLS', 'Schizophrenia', 'late-life schizophrenia'] @entity2146 :: ('MESH:D011595', 'Disease') :: ['Akathisia'] @entity505 :: ('MESH:D002244', 'Chemical') :: ['Carbon'] @entity21 :: ('MESH:D001480', 'Disease') :: ['Extrapyramidal symptoms', 'EPSs'] @entity1037 :: ('MESH:C076029', 'Chemical') :: ['olanzapine'] @entity11641 :: ('MESH:D020891', 'Chemical') :: ['raclopride'] @entity1090 :: ('MESH:D018967', 'Chemical') :: ['risperidone']
@entity161 :: (MESH:D012559,Disease) :: ['Schizophrenia']
