Antipsychotic Induced Dopamine Supersensitivity Psychosis: A Comprehensive Review.
Chronic prescription of antipsychotics seems to lose its therapeutic benefits in the prevention of recurring psychotic symptoms. In many instances, the occurrence of relapse from initial remission is followed by an increase in dose of the prescribed antipsychotic. The current understanding of why this occurs is still in its infancy, but a controversial idea that has regained attention recently is the notion of iatrogenic dopamine supersensitivity. Studies on cell cultures and animal models have shown that long-term antipsychotic use is linked to both an upregulation of dopamine D&lt;sub&gt;2&lt;/sub&gt;-receptors in the striatum and the emergence of enhanced receptor affinity to endogenous dopamine. These findings have been hypothesized to contribute to the phenomenon known as dopamine supersensitivity psychosis (DSP), which has been clinically typified as the foundation of rebound psychosis, drug tolerance, and tardive dyskinesia. The focus of this review is the update of evidence behind the classification of antipsychotic induced DSP and an investigation of its relationship to treatment resistance. Since antipsychotics are the foundation of illness management, a greater understanding of DSP and its prevention may greatly affect patient outcomes.
John
J
Yin
Alasdair M
AM
Barr
Alfredo
A
Ramos-Miguel
British Columbia Mental Health and Addictions Research Institute, A3-938 W 28th Avenue, Vancouver B.C., V5Z 4H4, Canada.
Ric M
RM
Procyshyn
D000818:Animals; D014150:Antipsychotic Agents / Q000009:adverse effects*; D015259:Dopamine Agents / Q000627:therapeutic use*; D005786:Gene Expression Regulation / Q000187:drug effects; D006801:Humans; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000209:etiology*; D017448:Receptors, Dopamine D2 / Q000378:metabolism
D014150:Antipsychotic Agents; D015259:Dopamine Agents; D017448:Receptors, Dopamine D2