Dopamine supersensitivity psychosis and dopamine partial agonist: a retrospective survey of failure of switching to aripiprazole in schizophrenia.
The administration of aripiprazole (ARI), a dopamine partial agonist, could provoke abrupt psychotic worsening in patients with schizophrenia. We explored the relationship between this psychotic worsening and dopamine supersensitivity psychosis (DSP), which is a clinically vulnerable state. We conducted a retrospective investigation for 264 patients whose treatment medication was switched to ARI from other antipsychotics. We divided the patients into the DSP(+) group with a history of DSP episode(s) (N = 70) and the DSP(-) group without such a history (N = 194), and then compared the clinical factors relevant to the success or failure of the switch to ARI between them. The results revealed that patients in the DSP(+) group experienced psychotic worsening following the switch to ARI with a significant higher rate compared to the DSP(-) group (23% vs. 8%, P < 0.01). Moreover, the dosages of the drugs before the ARI introduction in the patients experiencing the psychotic worsening in the DSP (-) group were higher than those in other patients of the group. Our findings suggest that patients who receive high dosages of antipsychotic drugs form overt or covert DSP and such state is highly associated with psychotic worsening following ARI treatment.
Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.
Masayuki
M
Takase
Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba, Japan kanahara@faculty.chiba-u.jp.
Nobuhisa
N
Kanahara
Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.
Yasunori
Y
Oda
Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.
Hiroshi
H
Kimura
Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba, Japan.
Hiroyuki
H
Watanabe
Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.
Masaomi
M
Iyo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000068180:Aripiprazole / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004298:Dopamine / Q000378:metabolism; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D054333:Drug Partial Agonism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011605:Psychoses, Substance-Induced / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D055815:Young Adult
D014150:Antipsychotic Agents; D018491:Dopamine Agonists; D000068180:Aripiprazole; D004298:Dopamine
Antipsychotic; dopamine partial agonist; dopamine supersensitivity; schizophrenia; tardive dyskinesia