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Is Bromocriptine a Dopamine Antagonist Treatment?-Reply

Dilip V. Jeste, MD; Richard Jed Wyatt, MD
Arch Gen Psychiatry. 1983;40(4):470. doi:10.1001/archpsyc.1983.01790040124024.
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In Reply—  The letter by Lieberman et al presents a new and interesting perspective on the studies of bromocriptine in the treatment of TD. Bromocriptine is believed to be a partial DA agonist. The main rationale for using low-dose bromocriptine in patients with TD has been a putative dopamine autoreceptor stimulation produced by the drug.1 Such an action would be expected to inhibit the synthesis and release of dopamine.2 Lieberman et al suggest that the relative inefficacy of bromocriptine in two reports1,3 may be attributable to the study design, while the beneficial effects of the drug in the third study4 might be explained on the basis of the attractive hypothesis of receptor sensitivity modification as postulated by Alpert and Friedhoff.5The explanation offered by Lieberman et al is quite plausible. It is likely that the doses of bromocriptine used in the earlier trials (10 mg or higher) were


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