Kanahara Nobuhisa, Kimura Hiroshi, Kinoshita Toshihiko, Iyo Masaomi, Takekita Yoshiteru
Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba, Japan.
Department of Psychiatry, Gakuji-kai Kimura Hospital, Chiba, Japan.
Clin Psychopharmacol Neurosci. 2023 Feb 28;21(1):197-201. doi: 10.9758/cpn.2023.21.1.197.
Dopamine supersensitivity psychosis (DSP) is an unstable clinical condition observed in individuals with schizophrenia who have been treated with an antipsychotic medication at a high dosage and/or for a long period. An up-regulation of dopamine D2 receptors (DRD2) is thought to be involved in the essential pathology of DSP. An antipsychotic agent with both tight binding to DRD2 and a long half-life is generally effective for treating DSP, but a patient who meets the criteria of treatment-resistant schizophrenia sometimes needs treatment with clozapine. We report the case details of two patients whose DSP was not controlled with several antipsychotics but was successfully controlled with asenapine. Asenapine binds to a broad range of dopamine receptors and serotonin receptors, and it is thus distinct from other atypical antipsychotics. The unique profile of asenapine may contribute to the control of severe DSP symptoms in individuals with schizophrenia.
多巴胺超敏性精神病（DSP）是一种不稳定的临床病症，见于长期接受高剂量抗精神病药物治疗的精神分裂症患者。多巴胺D2受体（DRD2）上调被认为参与了DSP的基本病理过程。一种与DRD2紧密结合且半衰期长的抗精神病药物通常对治疗DSP有效，但符合难治性精神分裂症标准的患者有时需要使用氯氮平治疗。我们报告了两名患者的病例详情，他们的DSP在使用多种抗精神病药物治疗时未得到控制，但使用阿立哌唑后成功得到控制。阿立哌唑与多种多巴胺受体和5-羟色胺受体结合，因此与其他非典型抗精神病药物不同。阿立哌唑的独特特性可能有助于控制精神分裂症患者的严重DSP症状。
