Rebound psychosis: effect of discontinuation of antipsychotics in Parkinson's disease.
To determine whether psychiatrically stable patients with a history of drug-induced psychosis could be successfully weaned off their antipsychotic drug, we offered consecutive Parkinson disease (PD) patients on quetiapine or clozapine, who were free of any on-going psychosis, to be slowly weaned off their antipsychotic drug. Before the study was aborted 6 PD patients (mean age, 78 years) with an average antipsychotic exposure of 20 months (5 on quetiapine, 1 on clozapine) were enrolled. After the antipsychotic agent was discontinued, psychosis recurred in 5 of 6 patients. In 3 patients the "rebound psychosis" was worse than the original psychotic episode and required subsequent higher antipsychotic medication doses.
Fernandez
Hubert H
HH
Department of Neurology, University of Florida/McKnight Brain Institute, Movement Disorders Program, Gainesville, Florida 32610, USA. fernandez@neurology.ufl.edu
Trieschmann
Martha E
ME
Okun
Michael S
MS
D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects*; D010054:Brief Psychiatric Rating Scale; D003024:Clozapine / Q000009:adverse effects*; D003987:Dibenzothiazepines / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000150:complications*; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy*; D000069348:Quetiapine Fumarate; D012008:Recurrence; D013997:Time Factors
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate; D003024:Clozapine