Adan-Manes J, Garcia-Parajua P
Department of Psychiatry, Hospital Puerta de Hierro, Universidad Autonoma de Madrid, Madrid, Spain.
J Clin Pharm Ther. 2009 Apr;34(2):245-6. doi: 10.1111/j.1365-2710.2008.00996.x.
Aripiprazole is a new generation antipsychotic drug with a partial agonist effect on dopamine D2 and D3 receptors. We report the case of a schizophrenic patient whose symptoms worsened after adding aripiprazole to another antipsychotic drug (amisulpiride). The physiopathology of this process seems to be mediated through the dopaminergic effect of aripiprazole in hypodopaminergic environments, caused by the administration of antipsychotic drugs such as amisulpiride. Besides this, the chronic administration of neuroleptic drugs may induce a hypersensitivity to dopamine agonists. In this context, we consider that the dopaminergic effect of aripiprazole may have induced a worsening of psychotic symptoms. We conclude that clinicians should be cautious when adding aripiprazole to patients under treatment with dopamine antagonists with a high affinity for D2 and D3 receptors.
阿立哌唑是一种对多巴胺D2和D3受体具有部分激动作用的新一代抗精神病药物。我们报告了一例精神分裂症患者的病例，该患者在另一种抗精神病药物（氨磺必利）基础上加用阿立哌唑后症状恶化。这一过程的病理生理学似乎是由阿立哌唑在低多巴胺能环境中的多巴胺能效应介导的，这种低多巴胺能环境是由使用氨磺必利等抗精神病药物引起的。除此之外，长期使用抗精神病药物可能会导致对多巴胺激动剂过敏。在此背景下，我们认为阿立哌唑的多巴胺能效应可能导致了精神症状恶化。我们得出结论，临床医生在给正在接受对D2和D3受体具有高亲和力的多巴胺拮抗剂治疗的患者加用阿立哌唑时应谨慎。
