The 5-HT2 receptor profiles of antipsychotics in the pathogenesis of obsessive-compulsive symptoms in schizophrenia.
Atypical antipsychotics have been reported to induce or exacerbate obsessive-compulsive symptoms (OCS) in patients with schizophrenia. We report the development of de novo obsession induced by sequential treatment with risperidone, aripiprazole, and ziprasidone, which have an antagonist effect on serotonin 5-HT(2A) receptors in a patient with schizophrenia. The obsession was repeatedly improved after switching the atypical antipsychotics to amisulpride, a selective D(2) and D(3) receptor antagonist. To our knowledge, this is the first report about ziprasidone-induced OCS in a patient with schizophrenia. In conclusion, this case supports the hypothesis that the antagonist effect on 5-HT(2) receptors may be related to atypical antipsychotic-induced OCS.
Kim
Sung-Wan
SW
Department of Psychiatry, Chonnam National University Medical School and Clinical Trial Center, Chonnam National University Hospital, Gwangju, Republic of Korea.
Shin
Il-Seon
IS
Kim
Jae-Min
JM
Youn
Tak
T
Yang
Su-Jin
SJ
Hwang
Michael Y
MY
Yoon
Jin-Sang
JS
D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000009:adverse effects*; D000068180:Aripiprazole; D018492:Dopamine Antagonists / Q000627:therapeutic use; D065127:Dopamine D2 Receptor Antagonists; D005260:Female; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000139:chemically induced* / Q000188:drug therapy / Q000378:metabolism; D010879:Piperazines / Q000009:adverse effects; D015363:Quinolones / Q000009:adverse effects; D017448:Receptors, Dopamine D2 / Q000187:drug effects; D050637:Receptors, Dopamine D3 / Q000037:antagonists & inhibitors / Q000187:drug effects; D044348:Receptors, Serotonin, 5-HT2 / Q000187:drug effects* / Q000378:metabolism; D018967:Risperidone / Q000009:adverse effects; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism*; D013469:Sulpiride / Q000031:analogs & derivatives / Q000627:therapeutic use; D013844:Thiazoles / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
D014150:Antipsychotic Agents; D018492:Dopamine Antagonists; D065127:Dopamine D2 Receptor Antagonists; D010879:Piperazines; D015363:Quinolones; D017448:Receptors, Dopamine D2; D050637:Receptors, Dopamine D3; D044348:Receptors, Serotonin, 5-HT2; D013844:Thiazoles; C092292:ziprasidone; D013469:Sulpiride; D000077582:Amisulpride; D000068180:Aripiprazole; D018967:Risperidone