Inagawa Takuma, Ueda Natsuki, Nakagome Kazuyuki, Sumiyoshi Tomiki
Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan.
Neuropsychopharmacol Rep. 2020 Jun;40(2):198-200. doi: 10.1002/npr2.12101. Epub 2020 Mar 15.
Dopamine (DA) hyperactivity causes overestimation of time, whereas DA hypoactivity produces its underestimation. DA activity also provides neurochemical substrates pertinent to several psychiatric conditions, such as schizophrenia and Tourette's syndrome. The overestimation of time sometimes exists in patients with Tourette's syndrome, but no reports have addressed time perception in relation to antipsychotic medications which typically act as DA receptor antagonists. We herein report a case of Tourette's syndrome, in which time estimation was differentially affected by risperidone (a DA antagonist) and aripiprazole (a DA partial agonist).
A 27-year-old man who suffered from verbal and motor tics was treated with risperidone. His tic symptoms disappeared; however, he began to experience a strange feeling that "time is going too fast." For example, "people walk more quickly compared to a normal pace." These complaints were thought to represent underestimation of time. Then, risperidone was switched to oral aripiprazole to optimize DA transmissions, which resulted in the amelioration of these subjective feelings.
Our observations indicate that the underestimation of time may occur in patients with Tourette's syndrome who receive antipsychotic drugs with high DA D receptor blocking potency. This may support the concept that the estimation of time is influenced by DA activity.
多巴胺（DA）活性亢进导致时间高估，而DA活性低下则导致时间低估。DA活性还为多种精神疾病提供神经化学底物，如精神分裂症和妥瑞氏综合征。时间高估有时存在于妥瑞氏综合征患者中，但尚无关于抗精神病药物（通常作为DA受体拮抗剂）对时间感知影响的报道。我们在此报告一例妥瑞氏综合征患者，其时间估计受利培酮（一种DA拮抗剂）和阿立哌唑（一种DA部分激动剂）的不同影响。
一名27岁患有言语和运动抽动的男性接受利培酮治疗。他的抽动症状消失了；然而，他开始体验到一种“时间过得太快”的奇怪感觉。例如，“人们走路的速度比正常速度快”。这些主诉被认为代表时间低估。然后，将利培酮换为口服阿立哌唑以优化DA传递，这导致这些主观感觉得到改善。
我们的观察表明，接受具有高DA D受体阻断效力的抗精神病药物的妥瑞氏综合征患者可能会出现时间低估。这可能支持时间估计受DA活性影响的概念。
