論文

国際誌
2020年11月

The effectiveness of very slow switching to aripiprazole in schizophrenia patients with dopamine supersensitivity psychosis: a case series from an open study.

International clinical psychopharmacology
  • Nobuhisa Kanahara
  • Masayuki Takase
  • Tsuyoshi Sasaki
  • Masanori Honma
  • Yasutaka Fujita
  • Shigenori Tadokoro
  • Hitoshi Suzuki
  • Hiroshi Yamanaka
  • Shingo Noda
  • Satoshi Yanahashi
  • Takahisa Saiga
  • Naoya Komatsu
  • Takeshi Simoyama
  • Masaomi Iyo
  • 全て表示

35
6
開始ページ
338
終了ページ
344
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1097/YIC.0000000000000322

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.

リンク情報
DOI
https://doi.org/10.1097/YIC.0000000000000322
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32868522
ID情報
  • DOI : 10.1097/YIC.0000000000000322
  • PubMed ID : 32868522

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