| Autor: |
Kanahara N; Department of Psychiatry, Chiba University Graduate School of Medicine.; Division of Medical Treatment and Rahabilitation, Chiba University Center for Forensic Mental Health.; Department of Psychiatry, Shirayuri-kai Ichihara Tsuruoka Hospital, Ichihara., Takase M; Department of Psychiatry, Chiba University Graduate School of Medicine., Sasaki T; Department of Child Psychiatry, Chiba University Hospital.; Department of Psychiatry, Chiba Hospital, Funabashi, Chiba., Honma M; Department of Psychiatry, Seijin-kai Suda Hospital, Takayama, Gifu., Fujita Y; Department of Psychiatry, Kousei-kai, Kusatsu Hospital, Hiroshima, Hiroshima., Tadokoro S; Department of Psychiatry, Seishin-kai Mobara Shinkeika Hospital, Mobara, Chiba.; Department of Liberal Arts, Health Administration Center, Muroran Institute of Technology, Muroran, Hokkaido., Suzuki H; Department of Psychiatry, Satsuki-kai Sodegaura Satsukidai Hospital, Sodegaura., Yamanaka H; Department of Psychiatry, Chiba Psychiatric Medical Center., Noda S; Department of Psychiatry, Shirayuri-kai Ichihara Tsuruoka Hospital, Ichihara., Yanahashi S; Department of Psychiatry, Shirayuri-kai Ichihara Tsuruoka Hospital, Ichihara., Saiga T; Department of Psychiatry, Narita Red Cross Hospital, Narita, Chiba., Komatsu N; Department of Psychiatry, Chiba Hospital, Funabashi, Chiba., Simoyama T; Department of Psychiatry, Matsuzaka Kousei Hospital, Matsuzaka, Mie, Japan., Iyo M; Department of Psychiatry, Chiba University Graduate School of Medicine. |
| Abstrakt: |
Dopamine supersensitivity psychosis (DSP) in patients with schizophrenia is induced by treatment with a high dosage of antipsychotics for a long time period, and it is characterized by unstable psychotic symptoms. The upregulation of dopamine D2 receptor (DRD2) provoked by antipsychotics underlies DSP. Aripiprazole does not cause an excessive blockade of DRD2 and is less likely to upregulate DRD2 by aripiprazole's dopamine partial agonistic profile. Aripiprazole; however, has a potential risk of inducing severe rebound psychosis in patients who have already developed dopamine supersensitivity. Recently, an animal model study suggested that aripiprazole could attenuate established dopamine supersensitivity. The present study was conducted to examine whether very slowly switching to aripiprazole could help patients with schizophrenia with dopamine supersensitivity while avoiding rebound psychosis. This study was a single-armed and open-labeled study in which patients were observed over a period of 2 years. Only 11 patients were ultimately recruited. Five patients were successfully switched to a sufficient dose of aripiprazole and completed the study protocol. These five patients did not present with severe DSP over the study period, but only one patient showed a large improvement in psychopathology. Five patients dropped out of the study, and one of these five showed a severe worsening of psychosis. The present study indicated that the introduction of aripiprazole in patients with DSP was difficult, but suggested that aripiprazole could contribute to attaining a stable state in psychosis if it was applied with careful observation. |
