1. Dopamine supersensitivity psychosis and dopamine partial agonist: a retrospective survey of failure of switching to aripiprazole in schizophrenia.
- Author
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Takase M, Kanahara N, Oda Y, Kimura H, Watanabe H, and Iyo M
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Antipsychotic Agents administration & dosage, Antipsychotic Agents adverse effects, Aripiprazole administration & dosage, Aripiprazole adverse effects, Dopamine metabolism, Dopamine Agonists administration & dosage, Dopamine Agonists adverse effects, Dopamine Agonists therapeutic use, Dose-Response Relationship, Drug, Drug Partial Agonism, Female, Humans, Male, Middle Aged, Psychoses, Substance-Induced epidemiology, Retrospective Studies, Young Adult, Antipsychotic Agents therapeutic use, Aripiprazole therapeutic use, Psychoses, Substance-Induced etiology, Schizophrenia drug therapy
- Abstract
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., Competing Interests: The following authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Takase reported honoraria from Otsuka. Dr Kanahara reported honoraria from Eli Lilly, Otsuka and Janssen. Dr Kimura reported honoraria from Janssen, Meiji Seika and Otsuka. Dr Watanabe received honoraria from Eli Lilly, Dainippon Sumitomo, Takeda and Mochida. Dr Iyo received a consultant fee from Eli Lilly, Dainippon Sumitomo, Pfizer and Abbott and reported honoraria from Janssen, Eli Lilly, Otsuka, Meiji Seika, Astellas, Dainippon Sumitomo, Ono, GlaxoSmithKline, Takeda, Shionogi, Hisamitsu and Asahi Kasei. Dr Oda declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2015.)
- Published
- 2015
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