|Beitragstitel||SGAs (Aripiprazole) after SGAs (zuclophentixole, haloperidol, flupentixole): case series and literature review.|
All antipsychotic medications attenuate the symptoms of psychosis by interacting with dopamine D2 receptors and reducing dopamine-mediated neurotransmission. However, long-term antipsychotic treatment can produce neuroadaptations that are thought to lead to dopamine supersensitivity. In patients with schizophrenia, this dopamine supersensitivity could compromise treatment efficacy, promote relapse to psychosis and trigger movement disorders. Such effects have been seen in patients treated with either typical or atypical antipsychotics . The aim of this report is to explain the relapse of a psychosis during the switch between FGAs (aripiprazole) to SGAs (haloperidol, zuclophentixole and fluopentixole).
Tree inpatients presenting with paranoid schizophrenia were assessed with the SCID-P for Axis I diagnosis, the positive and negative sympoms scale (PANNS) for the positive and negative symptoms in acute psychosis. We conducted a systematic literature review with the principal scientific databases (PubMed, Embase, PsychInfo) using the key terms “supersensitivity psychosis” and “schizophrenia”.
All the patients were diagnosed with paranoid schizophrenia and all the patients present a relapse in psychosis during the switching. We report the differece in the tree case report.
Discussion and conclusion
To our knowledge in the literature there are no studies that the relapse of a psychosis during the switch between SGAs (aripiprazole) to FGAs (haloperidol, zuclophentixole and fluopentixole). In our opinion this particular condition of neuroadaptations that are thought to lead to dopamine supersensitivity, is difficult to treat and is to play attention during the switch to FGAs to SGAs in particular aripiprazole for his typical partial agonist mechanism of action. Further research is warranted to replicate our clinical and qualitative observations and, in general, quantitative studies in large samples followed up over time are needed. Methodological limitations, clinical implications and suggestions for future research directions are considered.
 Servonnet A, et al., 2019.