[No rebound psychosis in a case of switching from clozapine to quetiapine].
OBJECTIVE
After rapid discontinuation of clozapine treatment rebound psychosis have been reported. Preexposure of D (2) receptors to clozapine may alter their affinity to endogenous dopamine. Clozapine withdrawal may also lead dysfunctional NMDA-receptors to cause dopamine release in the striatum.


METHODS
We report a case of a schizophrenic patient treated with clozapine 200 mg and aripiprazole 15 mg per day. After rapid clozapine discontinuation we added quetiapine up to 700 mg daily.


RESULTS
No rebound psychosis occurred. Even ten weeks after switching to quetiapine the patient's condition remained stable in the Brief Psychiatric Rating Scale.


CONCLUSIONS
The combination of aripiprazole and quetiapine seemed to control supersensitivity effects at the D (2) receptor after clozapin withdrawal in this case.
Walther
Sebastian
S
Universitäre Psychiatrische Dienste Bern, Schweiz. Sebastian.Walther@gef.be.ch
Baciu
Dan
D
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000068180:Aripiprazole; D001921:Brain / Q000187:drug effects; D010054:Brief Psychiatric Rating Scale; D003024:Clozapine / Q000008:administration & dosage / Q000009:adverse effects*; D003987:Dibenzothiazepines / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects; D000069348:Quetiapine Fumarate; D015363:Quinolones / Q000008:administration & dosage / Q000009:adverse effects; D017448:Receptors, Dopamine D2 / Q000187:drug effects; D012559:Schizophrenia / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D055502:Secondary Prevention; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D010879:Piperazines; D015363:Quinolones; D017448:Receptors, Dopamine D2; D000069348:Quetiapine Fumarate; D000068180:Aripiprazole; D003024:Clozapine