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Journal of Psychopharmacology
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Brain uptake of iomazenil in cirrhotic patients: a single photon emission tomography study

Flávio Kapczinski

Clinical Psychopharmacology Team, MRC, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, UK; Unidade de Psicofarmacologia, Serviço de Psiquiatria, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos 2350 90035–003, Porto Alegre, RS, Brazil kapcz{at}zaz.com.br

João Quevedo

H. Valerie Curran

Simon Fleminger

Clinical Psychopharmacology Team, MRC, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, UK

Brian Toone

Department of Psychological Medicine, King's College Hospital, London, UK

Alice Cluckie

Department of Nuclear Medicine, King's College Hospital, London, UK

Malcolm Lader

Clinical Psychopharmacology Team, MRC, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, UK,

Brain uptake of 123I-iomazenil was studied in seven cirrhotic patients and eight normal controls using single photon emission computerized tomography. The highest concentration of the ligand was found in the occipital cortex, which corresponds to the brain region with the highest concentration of benzodiazepine receptors.The peak uptake was delayed in patients across all brain regions. The uptake in occipital cortex was higher in low albumin cirrhotics. Patients with low albumin also presented a more delayed peak uptake in occipital cortex and a higher volume of distribution of iomazenil in plasma, compared to patients with normal albumin levels and controls. The changes in brain uptake (delayed peak uptake and increased maximal uptake in occipital cortex) appears to reflect changes in the pharmacokinetics of the ligand, particularly in cirrhotics with low levels of plasma albumin. The curve of brain uptake of the tracer was modelled into a two compartments equation, which seems to provide a practical and reliable method to calculate the slopes of acquisition and decay, time to peak and maximal acquisition.

Key Words: benzodiazepines • cirrhosis • 123I-iomazenil • single photon emission tomography • SPECT

Journal of Psychopharmacology, Vol. 13, No. 3, 219-225 (1999)
DOI: 10.1177/026988119901300302
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