Aripiprazole and Delusional Disorder

Iannuzzi, Gregory L; Patel, Ankita; Stewart, Jonathan T.

doi:10.1097/pra.0000000000000368

Cited by 4 publications

(4 citation statements)

References 25 publications

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“… 48 There are several reports of delusional disorder successful treatment with atypical antipsychotics such as risperidone, 49 olanzapine, 50 paliperidone, 51 and aripiprazole. 52 In addition, there are some reports of successful treatment with selective serotonin reuptake inhibitors (SSRIs) and clomipramine in monotherapy or in association with atypical antipsychotics, as some serotoninergic deficit may be involved in delusional disorder. 53 Noticeably, cariprazine also increases serotonin signaling in 5-HT1A receptors, suggesting why it may have a positive effect in this conditions improvement.…”

Section: Discussionmentioning

confidence: 99%

Cariprazine on Psychosis: Beyond Schizophrenia – A Case Series

Bajouco¹,

Mota²

2022

NDT

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Cariprazine is an atypical antipsychotic that has D2 and D3 partial agonism properties in addition to the usual 5-HT2A receptor antagonist action of second-generation antipsychotics. It has a distinctly higher affinity for D3 receptors, which is 10-fold higher than for D2 receptors. Cariprazine is also a 5-HT1A partial agonist, with a potential antidepressant effect. Cariprazine has been approved for treatment of both positive and negative symptoms of schizophrenia and for treatment of bipolar disorder. It could potentially be used in depression as an add-on treatment. There are few data reporting effectiveness of cariprazine in the broader spectrum of psychosis. In this paper, the authors report three cases where cariprazine was used in the treatment of psychotic conditions other than schizophrenia, namely a first episode psychosis, a case of delusional disorder, and a case of a patient with borderline personality disorder and psychotic symptoms. The authors suggest that cariprazine may be effective in the treatment of psychosis in a broader sense and should be considered a first-line treatment option.

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Section: Discussionmentioning

confidence: 99%

Cariprazine on Psychosis: Beyond Schizophrenia – A Case Series

Bajouco¹,

Mota²

2022

NDT

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“…All reviewed studies reported significant clinical improvement. Furthermore, aripiprazole was shown to ameliorate psychotic symptoms in some individuals who did not respond to risperidone, perhaps because extrapyramidal and hyperprolactinemic effects were avoided [ 58 ].…”

Section: Use Of Partial D2 Agonistsmentioning

confidence: 99%

Seventy Years of Treating Delusional Disorder with Antipsychotics: A Historical Perspective

et al. 2022

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For many decades, delusional disorder (DD) has been considered a treatment-resistant disorder, with antipsychotics acknowledged as the best, though imperfect, treatment. It is possible that the discovery of the right drug could turn treatment resistance into treatment response. The goal of this narrative review is to provide a historical perspective of the treatment of DD since the introduction of antipsychotics 70 years ago. The following search terms were used to scan the literature: antipsychotics AND “delusional disorder”. Findings were that therapy for DD symptoms has changed over time. Initial reports suggested that the drug of choice was the antipsychotic pimozide, and that this drug was especially effective for the somatic subtype of DD. Subsequent studies demonstrated that other antipsychotics, for instance, risperidone and olanzapine, were also highly effective. Treatment response may vary according to the presence or absence of specific symptoms, such as cognitive defect and depression. Clozapine, partial D2 agonists, and long-acting injectable drugs may be more effective than other drugs, but the evidence is not yet in. Because of the absence of robust evidence, treatment guidelines for the optimal management of DD are not yet available.

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“…In the case involving problem gambling reported by Peteru and Giri 3 in this issue, we can surmise that unbalanced, excessive stimulation of dopamine even at the "partial agonist" level was somehow to blame. It is harder to account for the enhanced efficacy over other antipsychotics in delusional disorder described in the case report by Iannuzzi et al 1 or the dramatic weight loss described in the case report by Boland and Chhabra. 2 The take home lesson is that, within the broad class of second-generation antipsychotics, there are sufficient distinctions between individual medications to warrant continued, sequential trials in psychotic disorders and mood disorders when results are suboptimal.…”

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confidence: 97%

“…The 3 related case reports presented in this issue of the Journal [1][2][3] describe circumstances in which aripiprazole demonstrated unique, clinically observable actions compared with its predecessors among second-generation, or atypical, antipsychotics. The original wave of second-generation antipsychotics consisted of dopamine D 2 antagonists, with the addition of 5-HT2A antagonism to mitigate extrapyramidal side effects by selectively enhancing nigrostriatal dopamine transmission.…”

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confidence: 99%

Commentary: Aripiprazole: The Second Wave of the Second-generation Antipsychotics

Kahn

2019

Journal of Psychiatric Practice

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Three cases are presented describing unique clinical responses to aripiprazole in comparison with other second-generation antipsychotics taken by each patient. One case involved an adverse reaction of problem gambling behavior, the second an enhanced antipsychotic response in delusional disorder, and the third a reversal of weight gain that occurred while the patient continued taking olanzapine. Aripiprazole was the first of a subgroup of atypical antipsychotics that are mixed agonists and antagonists of dopamine, likely contributing to unusual responses in some patients.

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Aripiprazole and Delusional Disorder

Cited by 4 publications

References 25 publications

Cariprazine on Psychosis: Beyond Schizophrenia – A Case Series

Cariprazine on Psychosis: Beyond Schizophrenia – A Case Series

Seventy Years of Treating Delusional Disorder with Antipsychotics: A Historical Perspective

Commentary: Aripiprazole: The Second Wave of the Second-generation Antipsychotics

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