Severe cases of neuroleptic-induced supersensitivity psychosis. Diagnostic criteria for the disorder and its treatment.

1: Schizophr Res. 1991 Jul-Aug;5(1):21-33.

Psychiatric Research Center, Louis-H. Lafontaine Hospital, University of Montreal, Quebec, Canada.

Tardive dyskinesia is thought to result from neostriatal dopaminergic receptor supersensitivity induced by chronic treatment with neuroleptics. Similarly, receptor supersensitivity occurring in other dopaminergic regions of the brain could result in the development of supersensitivity psychosis. As with tardive dyskinesia, severe forms of the disorder are rare. Ten such cases are described whose main characteristic is that psychotic symptoms can no longer be masked by increased dosages of neuroleptics. Diagnostic criteria for the disorder are proposed, and treatment with antiepileptic medication is described.

PMID: 1677263 [PubMed - indexed for MEDLINE]

Neuroleptic-induced supersensitivity psychosis in patients with bipolar affective disorder.

Clinical Psychopharmacology Unit, Allan Memorial Institute, Royal Victoria Hospital, Montreal, Quebec, Canada.

Clinical syndromes thought to arise from neuroleptic-induced dopamine receptor supersensitivity are well described in psychiatry. Tardive dyskinesia may arise from neostriatal supersensitivity and supersensitivity psychosis may arise from mesolimbic supersensitivity in schizophrenics chronically treated with neuroleptics. The authors present 5 cases of supersensitivity psychosis that developed in patients with bipolar affective disorder. The clinical syndrome is described and the implications for the long-term course of bipolar affective disorder are discussed.

PMID: 1972608 [PubMed - indexed for MEDLINE]

Neuroleptic-induced supersensitivity psychosis: clinical and pharmacologic characteristics.

Tardive dyskinesia is thought to result from neostriatal dopaminergic receptor supersensitivity induced by chronic treatment with neuroleptics. The authors suggest that dopaminergic supersensitivity also occurs in the mesolimbic region after chronic neuroleptic exposure, resulting in the development of a supersensitivity psychosis. Neuroleptic-induced supersensitivity psychosis is illustrated by data from 10 patients that demonstrate the syndrome's clinical and pharmacologic characteristics. An implication of neuroleptic-induced mesolimbic supersensitivity is that the tenaency toward psychotic relapse in such patients is determined by more than just the normal course of the illness.

PMID: 6101522 [PubMed - indexed for MEDLINE]

Neuroleptic-induced supersensitivity psychosis: retrospective study of schizophrenic inpatients.

Department of Psychiatry, Medical College of Pennsylvania/Eastern Pennsylvania Psychiatric Institute, Philadelphia 19129.

Chouinard has suggested that a significant number of schizophrenic outpatients may rapidly relapse after discontinuing or abruptly reducing antipsychotic drugs, and he has hypothesized that this relapse reflects a supersensitivity psychosis related to mesolimbic postsynaptic dopamine supersensitivity caused by drug therapy. Using Chouinard's criteria, the authors found 12 probable but no definitive cases of this syndrome while conducting a chart review of 265 hospitalized schizophrenic patients. Six of the 12 patients were subsequently rediagnosed as schizoaffective. Four patients had tardive dyskinesia, but this condition did not worsen after the drug dosage was decreased. Although supersensitivity psychosis was not common among this population, further study of the syndrome is needed to determine if neuroleptics are causing a subgroup of patients to relapse early or if the early relapses are a manifestation of the natural course of illness in these patients.

PMID: 2899071 [PubMed - indexed for MEDLINE]

Neuroleptic withdrawal in patients meeting criteria for supersensitivity psychosis.

Medical College of Pennsylvania, Eastern Pennsylvania Psychiatric Institute, Philadelphia 19129.

In an attempt to prospectively validate the existence of supersensitivity psychosis (SSP), five schizophrenic patients meeting Chouinard's criteria for SSP and five non-SSP schizophrenic controls had neuroleptic treatment withdrawn for 2 weeks under double-blind conditions. The sudden worsening of psychotic symptoms and tardive dyskinesia postulated in the SSP group was not observed on the Brief Psychiatric Rating Scale, the Clinical Global Impressions scale, and the Abbreviated Dyskinesia Rating Scale. In conclusion, the authors' pilot data do not seem to support the existence of SSP.

PMID: 1974249 [PubMed - indexed for MEDLINE]