The effectiveness of very slow switching to aripiprazole in schizophrenia patients with dopamine supersensitivity psychosis: a case series from an open study.
Journal
International clinical psychopharmacology
ISSN: 1473-5857
Titre abrégé: Int Clin Psychopharmacol
Pays: England
ID NLM: 8609061
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
pubmed:
2
9
2020
medline:
29
9
2021
entrez:
2
9
2020
Statut:
ppublish
Résumé
Dopamine supersensitivity psychosis (DSP) in patients with schizophrenia is induced by treatment with a high dosage of antipsychotics for a long time period, and it is characterized by unstable psychotic symptoms. The upregulation of dopamine D2 receptor (DRD2) provoked by antipsychotics underlies DSP. Aripiprazole does not cause an excessive blockade of DRD2 and is less likely to upregulate DRD2 by aripiprazole's dopamine partial agonistic profile. Aripiprazole; however, has a potential risk of inducing severe rebound psychosis in patients who have already developed dopamine supersensitivity. Recently, an animal model study suggested that aripiprazole could attenuate established dopamine supersensitivity. The present study was conducted to examine whether very slowly switching to aripiprazole could help patients with schizophrenia with dopamine supersensitivity while avoiding rebound psychosis. This study was a single-armed and open-labeled study in which patients were observed over a period of 2 years. Only 11 patients were ultimately recruited. Five patients were successfully switched to a sufficient dose of aripiprazole and completed the study protocol. These five patients did not present with severe DSP over the study period, but only one patient showed a large improvement in psychopathology. Five patients dropped out of the study, and one of these five showed a severe worsening of psychosis. The present study indicated that the introduction of aripiprazole in patients with DSP was difficult, but suggested that aripiprazole could contribute to attaining a stable state in psychosis if it was applied with careful observation.
Identifiants
pubmed: 32868522
doi: 10.1097/YIC.0000000000000322
pii: 00004850-202011000-00007
doi:
Substances chimiques
Antipsychotic Agents
0
Dopamine Agonists
0
Dopamine D2 Receptor Antagonists
0
Aripiprazole
82VFR53I78
Dopamine
VTD58H1Z2X
Types de publication
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
338-344Références
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