1 Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.
2 Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba, Japan.
J Psychopharmacol. 2017 Dec;31(12):1511-1518. doi: 10.1177/0269881117728428. Epub 2017 Sep 19.
Dopamine supersensitivity psychosis (DSP) is observed in patients with schizophrenia under antipsychotic treatment, and it is characterized by rebound psychosis, an uncontrollable psychotic episode following a stable state and tardive dyskinesia. DSP, first described in patients taking typical antipsychotics in the late 1970s, sometimes appears even in patients who are treated with current atypical antipsychotics. It was recently demonstrated that DSP can have a negative impact on the long-term prognosis of schizophrenia patients and that DSP could be involved in the etiology of some cases of treatment-resistant schizophrenia. Accumulating evidence suggests that an up-regulation of dopamine D2 receptors (DRD2) in the brain caused by long-term exposure to antipsychotics is related to the DSP phenomenon. The present review describes the clinical characteristics and the etiology of DSP in the era of second-generation antipsychotics for patients with schizophrenia. Based on the mechanism of DSP, several potential treatments for patients presenting with a DSP episode or the dopamine supersensitivity state are also discussed.
多巴胺超敏性精神病(DSP)见于接受抗精神病药物治疗的精神分裂症患者,其特征为反弹精神病,即在稳定状态后出现无法控制的精神病发作和迟发性运动障碍。DSP 于 20 世纪 70 年代末首次在服用典型抗精神病药的患者中描述,有时甚至出现在目前使用非典型抗精神病药治疗的患者中。最近的研究表明,DSP 会对精神分裂症患者的长期预后产生负面影响,并且 DSP 可能与某些治疗抵抗性精神分裂症病例的病因有关。越来越多的证据表明,大脑中多巴胺 D2 受体(DRD2)长期暴露于抗精神病药物引起的上调与 DSP 现象有关。本综述描述了第二代抗精神病药时代精神分裂症患者的 DSP 的临床特征和病因。基于 DSP 的机制,还讨论了几种潜在的治疗方法,用于治疗出现 DSP 发作或多巴胺超敏状态的患者。