Takase Masayuki, Kanahara Nobuhisa, Oda Yasunori, Kimura Hiroshi, Watanabe Hiroyuki, Iyo Masaomi
Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.
Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba, Japan
J Psychopharmacol. 2015 Apr;29(4):383-9. doi: 10.1177/0269881115570083. Epub 2015 Mar 3.
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.
阿立哌唑（ARI）作为一种多巴胺部分激动剂，在精神分裂症患者中使用时可能会引发精神病症状突然恶化。我们探讨了这种精神病症状恶化与多巴胺超敏性精神病（DSP）之间的关系，DSP是一种临床易患状态。我们对264例治疗药物从其他抗精神病药物换为ARI的患者进行了回顾性调查。我们将患者分为有DSP发作史的DSP(+)组（N = 70）和无此病史的DSP(-)组（N = 194），然后比较两组之间与换用ARI成功或失败相关的临床因素。结果显示，与DSP(-)组相比，DSP(+)组患者换用ARI后出现精神病症状恶化的比例显著更高（23%对8%，P < 0.01）。此外，在DSP(-)组中出现精神病症状恶化的患者在引入ARI之前的用药剂量高于该组其他患者。我们的研究结果表明，接受高剂量抗精神病药物治疗的患者会形成显性或隐性DSP，这种状态与ARI治疗后精神病症状恶化高度相关。
