A prospective comparative study of risperidone long-acting injectable for treatment-resistant schizophrenia with dopamine supersensitivity psychosis

Kimura, Hiroshi; Kanahara, Nobuhisa; Komatsu, Naoya; Ishige, Minoru; Muneoka, Katsumasa; Yoshimura, M.; Yamanaka, Hiroshi; Suzuki, Tomotaka; Kobara, Hideki; Sasaki, Tsuyoshi; Hashimoto, Tasuku; Hasegawa, Tadashi; Shiina, Akihiro; Ishikawa, Masatomo; Sekine, Yoshimoto; Shiraishi, Tetsuya; Watanabe, Hiroyuki; Shimizu, Eiji; Hashimoto, Kenji; Iyo, Masaomi

doi:10.1016/j.schres.2014.02.022

Cited by 50 publications

(70 citation statements)

References 43 publications

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“…We will review 3 studies [34,35,36], 2 specifically focusing on TR schizophrenia (online suppl. Table 2).…”

Section: Clinical Characteristics and Consequences Of Sp In The Era Omentioning

confidence: 99%

“…In the second study of SP by Kimura et al [34], LA injectable risperidone was given as adjunctive therapy to TR schizophrenia in a 1-year multicenter prospective follow-up study ( n = 115). Patients were diagnosed as having SP if they met at least one of Chouinard's [14] criteria: withdrawal psychosis, tolerance to antipsychotic effects, new psychotic symptoms, or symptoms of greater severity upon drug discontinuation/dose reduction, and a history or presence or TD.…”

Section: Clinical Characteristics and Consequences Of Sp In The Era Omentioning

confidence: 99%

“…Table 2). The prevalence of SP in TR schizophrenia was 65% (61/94) [34]. At baseline, schizophrenia patients with SP had higher total scores for drug-induced movement disorders on the Extrapyramidal Symptom Rating Scale (ESRS) [81,82] and higher scores on the negative symptoms subscale of the BPRS [83].…”

Section: Clinical Characteristics and Consequences Of Sp In The Era Omentioning

confidence: 99%

“…At baseline, schizophrenia patients with SP had higher total scores for drug-induced movement disorders on the Extrapyramidal Symptom Rating Scale (ESRS) [81,82] and higher scores on the negative symptoms subscale of the BPRS [83]. Both SP and non-SP groups improved with adjunctive LA injectable risperidone, but the SP group showed significantly greater improvement in the BPRS total score and had a greater number of drug responders [34] (online suppl. Table 2).…”

Section: Clinical Characteristics and Consequences Of Sp In The Era Omentioning

confidence: 99%

“…Three recent studies [34,35,36], including a total of 505 schizophrenic patients treated with SGAs, have found that the prevalence rates of SP remain high (30%) in schizophrenia ( n = 261) and higher (70%) in treatment-resistant (TR) schizophrenia ( n = 241). Using TD to identify SP, Fallon and Dursun [37] and Fallon et al [38] found that SP could be the cause of relapse in 30-40% of schizophrenic patients.…”

Section: Introductionmentioning

confidence: 99%

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Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy

Chouinard

Samaha

Chouinard

et al. 2017

Psychother Psychosom

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The first-line treatment for psychotic disorders remains antipsychotic drugs with receptor antagonist properties at D₂-like dopamine receptors. However, long-term administration of antipsychotics can upregulate D₂ receptors and produce receptor supersensitivity manifested by behavioral supersensitivity to dopamine stimulation in animals, and movement disorders and supersensitivity psychosis (SP) in patients. Antipsychotic-induced SP was first described as the emergence of psychotic symptoms with tardive dyskinesia (TD) and a fall in prolactin levels following drug discontinuation. In the era of first-generation antipsychotics, 4 clinical features characterized drug-induced SP: rapid relapse after drug discontinuation/dose reduction/switch of antipsychotics, tolerance to previously observed therapeutic effects, co-occurring TD, and psychotic exacerbation by life stressors. We review 3 recent studies on the prevalence rates of SP, and the link to treatment resistance and psychotic relapse in the era of second-generation antipsychotics (risperidone, paliperidone, perospirone, and long-acting injectable risperidone, olanzapine, quetiapine, and aripiprazole). These studies show that the prevalence rates of SP remain high in schizophrenia (30%) and higher (70%) in treatment-resistant schizophrenia. We then present neurobehavioral findings on antipsychotic-induced supersensitivity to dopamine from animal studies. Next, we propose criteria for SP, which describe psychotic symptoms and co-occurring movement disorders more precisely. Detection of mild/borderline drug-induced movement disorders permits early recognition of overblockade of D₂ receptors, responsible for SP and TD. Finally, we describe 3 antipsychotic withdrawal syndromes, similar to those seen with other CNS drugs, and we propose approaches to treat, potentially prevent, or temporarily manage SP.

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“…We will review 3 studies [34,35,36], 2 specifically focusing on TR schizophrenia (online suppl. Table 2).…”

Section: Clinical Characteristics and Consequences Of Sp In The Era Omentioning

confidence: 99%

Section: Clinical Characteristics and Consequences Of Sp In The Era Omentioning

confidence: 99%

Section: Clinical Characteristics and Consequences Of Sp In The Era Omentioning

confidence: 99%

Section: Clinical Characteristics and Consequences Of Sp In The Era Omentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy

Chouinard

Samaha

Chouinard

et al. 2017

Psychother Psychosom

Self Cite

222

227

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What is the risk‐benefit ratio of long‐term antipsychotic treatment in people with schizophrenia?

2018

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The long-term benefit-to-risk ratio of sustained antipsychotic treatment for schizophrenia has recently been questioned. In this paper, we critically examine the literature on the long-term efficacy and effectiveness of this treatment. We also review the evidence on the undesired effects, the impact on physical morbidity and mortality, as well as the neurobiological correlates of chronic exposure to antipsychotics. Finally, we summarize factors that affect the risk-benefit ratio. There is consistent evidence supporting the efficacy of antipsychotics in the short term and mid term following stabilization of acute psychotic symptoms. There is insufficient evidence supporting the notion that this effect changes in the long term. Most, but not all, of the long-term cohort studies find a decrease in efficacy during chronic treatment with antipsychotics. However, these results are inconclusive, given the extensive risk of bias, including increasing non-adherence. On the other hand, long-term studies based on national registries, which have lower risk of bias, find an advantage in terms of effectiveness during sustained antipsychotic treatment. Sustained antipsychotic treatment has been also consistently associated with lower mortality in people with schizophrenia compared to no antipsychotic treatment. Nevertheless, chronic antipsychotic use is associated with metabolic disturbance and tardive dyskinesia. The latter is the clearest undesired clinical consequence of brain functioning as a potential result of chronic antipsychotic exposure, likely from dopaminergic hypersensitivity, without otherwise clear evidence of other irreversible neurobiological changes. Adjunctive psychosocial interventions seem critical for achieving recovery. However, overall, the current literature does not support the safe reduction of antipsychotic dosages by 50% or more in stabilized individuals receiving adjunctive psychosocial interventions. In conclusion, the critical appraisal of the literature indicates that, although chronic antipsychotic use can be associated with undesirable neurologic and metabolic side effects, the evidence supporting its long-term efficacy and effectiveness, including impact on life expectancy, outweighs the evidence against this practice, overall indicating a favorable benefit-to-risk ratio. However, the finding that a minority of individuals diagnosed initially with schizophrenia appear to be relapse free for long periods, despite absence of sustained antipsychotic treatment, calls for further research on patient-level predictors of positive outcomes in people with an initial psychotic presentation.

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Treatment-Resistant Schizophrenia: Assessment and Management

Grover

Garekar

Agarwal

2018

Treatment Resistance in Psychiatry

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A prospective comparative study of risperidone long-acting injectable for treatment-resistant schizophrenia with dopamine supersensitivity psychosis

Abstract: UMIN (UMIN000008487).

Cited by 50 publications

References 43 publications

Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy

Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy

What is the risk‐benefit ratio of long‐term antipsychotic treatment in people with schizophrenia?

Treatment-Resistant Schizophrenia: Assessment and Management

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