Risperidonintoxikation bei genetischer Disposition als „poor [non]metabolizer”

Strauß, Maria; Heinritz, Wolfram; Hegerl, Ulrich; Kopf, Andrea

doi:10.1055/s-0029-1223511

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…Pimozide is equally effective in other psychotic syndromes, but is currently rarely used because of cardiac toxicity. Similarly, all antipsychotic medications are effective in DD treatment, though tolerability and, thus, adherence differ [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ]. The mechanism of action is generally attributable to action on dopamine and serotonin pathways, though other neurotransmitters may also be involved.…”

Section: Discussionmentioning

confidence: 99%

“…This drug is chiefly metabolized by CYP2D6. A case report by Strauss and collaborators rightly highlighted the relevance of genetic variants of CYP2D6 when treating DD with risperidone [ 38 ]. The patient was a 37-year-old woman who was a poor metabolizer of risperidone, and in whom a very low dose proved toxic.…”

Section: Use Of Second-generation Antipsychotics In the Treatment Of ...mentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Use Of Second-generation Antipsychotics In the Treatment Of ...mentioning

confidence: 99%

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

et al. 2022

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“…Strauss and collaborators reported the case of a 37-year-old woman with DD treated with risperidone [ 106 ]. High plasma levels suggest a potential metabolic disorder, particularly an unusual genetic polymorphism in the CYP2D6 gene.…”

Section: Collaboration With Pharmacologistsmentioning

confidence: 99%

Collaboration between Psychiatrists and Other Allied Medical Specialists for the Treatment of Delusional Disorders

et al. 2022

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Background: There is increasing evidence that individuals with psychosis are at increased risk for cardiovascular disease, diabetes, metabolic syndrome, and several other medical comorbidities. In delusional disorder (DD), this is particularly so because of the relatively late onset age. Aims: The aim of this narrative review is to synthesize the literature on the necessity for medical collaboration between psychiatrists and other specialists. Methods: A non-systematic narrative review was carried out of papers addressing referrals and cooperation among specialists in the care of DD patients. Results: Psychiatrists, the primary care providers for DD patients, depend on neurology to assess cognitive defects and rule out organic sources of delusions. Neurologists rely on psychiatry to help with patient adherence to treatment and the management of psychotropic drug side effects. Psychiatrists require ophthalmology/otolaryngology to treat sensory deficits that often precede delusions; reciprocally, psychiatric consults can help in instances of functional sensory impairment. Close collaboration with dermatologists is essential for treating delusional parasitosis and dysmorphophobia to ensure timely referrals to psychiatry. Conclusions: This review offers many other examples from the literature of the extent of overlap among medical specialties in the evaluation and effective treatment of DD. Optimal patient care requires close collaboration among specialties.

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“…Nebenwirkungen bei Gabe von 300 mg / d Venlafaxin) kein Hinweis. Polymorphismen bei CYP 2D6 mit einer resultierenden verminderten Aktivität treten bei 5-8 % der mitteleuropäischen Bevölkerung auf und können selbst bei geringer Dosierung von Pharmaka, die Substrat von 2D6 sind, mit heftigen Intoxikationssymptomen einhergehen [11]. Über CYP 2D6 läuft ein Abbauweg von Venlafaxin, der andere über CYP 3A4.…”

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QTc-Zeit-Verlängerung unter Therapie mit Agomelatin

Kozian¹,

Syrbe²

2010

Psychiat Prax

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Risperidonintoxikation bei genetischer Disposition als „poor [non]metabolizer”

Abstract: In intoxications with psychoactive agents, the presence of an enzyme defect in the P450 system should be considered as an additional possible cause.

Cited by 3 publications

References 6 publications

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

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

Collaboration between Psychiatrists and Other Allied Medical Specialists for the Treatment of Delusional Disorders

QTc-Zeit-Verlängerung unter Therapie mit Agomelatin

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