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Dopamine supersensitivity psychosis as a pivotal factor in treatment-resistant schizophrenia

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firemonkee57

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Mar 23, 2009
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Dopamine supersensitivity psychosis as a pivotal factor in treatment-resistant schizophrenia

Highlights

•Dopamine supersensitivity psychosis (DSP) in schizophrenia is characterized by unstable psychosis and/or tardive dyskinesia (TD).
•The development of DSP is promoted by long-term antipsychotic treatment.
•We investigated the role of DSP in treatment-resistant schizophrenia (TRS) which shows both a lesser response to and intolerance to pharmacotherapy.
•Approximately 70% of the patients in our TRS cohort had experienced at least a single DSP episode at some point during treatment.
•This finding strongly suggests that these DSP may play an important role in the process leading to treatment refractoriness in schizophrenia.

Abstract

There may be subtypes in treatment-resistant schizophrenia (TRS), and one of the subtypes may be related to dopamine supersensitivity psychosis (DSP). In developing strategies for prevention and treatment TRS, it is important to clarify the role of DSP in TRS. TRS patients were recruited from 3 hospitals for the present study. Through chart reviews, all patients were judged as either TRS or not, and then possible TRS patients were investigated about their past/present histories of DSP episode(s) by direct interviews. We then compared each factor between the groups with and without DSP episode(s). Out of 611 patients screened, 147 patients met the criteria for TRS and were included in the present analysis. These were divided into groups with and without DSP, comprising 106 (72.1%) and 41 patients (27.9%), respectively. Clinical characteristics in the two groups were similar, except for drug-induced movement disorders (DIDMs), which were significantly more important in DSP patients. Of the DSP patients, 42% and 56% experienced rebound psychosis and tolerance to antipsychotic effects, respectively. The present study revealed that approximately 70% of TRS patients experienced one or more DSP episodes, which may have a strong impact on the long-term prognosis of patients with schizophrenia.
Keywords:
Antipsychotics, Clinical course, Deficit syndrome, Dopamine D2 receptor, Prognosis, Tardive dyskinesia, Treatment-resistant


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SarahD

SarahD

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Oct 21, 2014
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This is very interesting! I am sure my psychosis is worse since I was on antipsychotics. And I have TD. Although my length of treatment wasn't all that long. I certainly have an intolerance to 'pharmacotherapy'!

Think I will copy this for my psych, won't make any difference though.
 
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