title: Psychotic exacerbation and emotional dampening in the daily life of patients with schizophrenia switched to aripiprazole therapy: a collection of standardized case reports.
abstract: BACKGROUND
  Blockade of the dopamine D2 receptor is a key mechanism in the antipsychotic treatment of patients with a psychotic disorder, but may also induce emotional deficits. The partial D2 agonistic profile of aripiprazole has, therefore, been suggested to favor emotional wellbeing compared with the pure dopamine antagonistic properties of traditional antipsychotics.
  
  
  METHODS
  The current study used the experience sampling method (a structured diary technique) to assess the effects of switching from treatment with traditional dopamine antagonist antipsychotics to treatment with the partial dopamine agonist aripiprazole on emotional wellbeing in the daily life of 13 patients with a diagnosis of schizophrenia.
  
  
  RESULTS
  More than half of all patients experienced exacerbation of psychotic symptoms after they had switched to the aripiprazole medication regime, consequently resulting in dropout of the study. Furthermore, switching to aripiprazole treatment, when effective in terms of symptom reduction, was accompanied by decreased feelings of both positive and negative affect in daily life, suggestive of a general state of emotional dampening.
  
  
  CONCLUSIONS
  Although the scale of the current study and the 54% dropout rate call for careful interpretation of the data, implementation of ecological monitoring in psychopharmacological research may open up new avenues for untangling the working mechanisms of compounds with regard to their impact on mental states.
authors: Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Center, The Netherlands.
authors: Johan
authors: J
authors: Lataster
authors: Inez
authors: I
authors: Myin-Germeys
authors: Marieke
authors: M
authors: Wichers
authors: Philippe A E G
authors: PA
authors: Delespaul
authors: J
authors: J
authors: van Os
authors: Maarten
authors: M
authors: Bak
keywords: affect; antipsychotic; aripiprazole; daily life; dopamine; emotions; psychosis; schizophrenia
references: CNS Drugs. 2009 Sep;23(9):773-80
references: 19689167
references: J Clin Pharm Ther. 2009 Apr;34(2):245-6
references: 19250146
references: Int Clin Psychopharmacol. 2004 Jan;19(1):45-8
references: 15101571
references: Pharmacopsychiatry. 2011 May;44(3):109-13
references: 21432752
references: J Clin Psychiatry. 2003 Jun;64(6):663-7
references: 12823080
references: Eur Neuropsychopharmacol. 2009 Aug;19(8):562-70
references: 19442491
references: Brain Res Brain Res Rev. 1998 Dec;28(3):309-69
references: 9858756
references: Psychol Med. 2001 Apr;31(3):489-98
references: 11305857
references: J Psychopharmacol. 2005 Jul;19(4):408-13
references: 15982997
references: Int Clin Psychopharmacol. 2006 Jan;21(1):63-9
references: 16317319
references: Arch Gen Psychiatry. 1981 Feb;38(2):187-90
references: 7212946
references: Trends Pharmacol Sci. 2004 Aug;25(8):402-6
references: 15276708
references: Neuropsychopharmacology. 1988 Sep;1(3):179-86
references: 3075131
references: J Clin Psychopharmacol. 1995 Feb;15(1 Suppl 1):2S-3S
references: 7730497
references: Neuroscience. 2010 Apr 14;166(4):1023-35
references: 20109531
references: Am J Psychiatry. 2001 Mar;158(3):360-9
references: 11229973
references: Int Clin Psychopharmacol. 1995 Sep;10 Suppl 3:133-8
references: 8866775
references: Arch Gen Psychiatry. 1991 Aug;48(8):764-70
references: 1883262
references: Clin Neuropharmacol. 2009 Sep-Oct;32(5):243-9
references: 19620849
references: J Clin Psychiatry. 2010 Nov;71(11):1447-56
references: 20584524
references: J Clin Psychiatry. 2001 Nov;62(11):841-2
references: 11775041
references: Am J Psychiatry. 2006 Mar;163(3):488-93
references: 16513871
references: Trends Pharmacol Sci. 2004 Sep;25(9):481-6
references: 15559250
references: J Clin Psychiatry. 2011 Oct;72(10):1397-404
references: 21208588
references: Psychol Med. 2009 Sep;39(9):1533-47
references: 19215626
references: J Clin Psychiatry. 2001 Dec;62(12):923-4
references: 11780870
references: Int J Neuropsychopharmacol. 2009 Jun;12(5):715-21
references: 19366489