Title:Antipsychotic Induced Dopamine Supersensitivity Psychosis: A Comprehensive Review
Volume: 15
Issue: 1
Author(s): John Yin, Alasdair M. Barr, Alfredo Ramos-Miguel and Ric M. Procyshyn
Affiliation:
Keywords:
Antipsychotics, dopamine supersensitivity psychosis, D2-receptors, rebound psychosis, relapse, schizophrenia,
treatment-resistance, tolerance.
Abstract: Chronic prescription of antipsychotics seems to lose its therapeutic
benefits in the prevention of recurring psychotic symptoms. In many instances, the
occurrence of relapse from initial remission is followed by an increase in dose of the
prescribed antipsychotic. The current understanding of why this occurs is still in its
infancy, but a controversial idea that has regained attention recently is the notion of
iatrogenic dopamine supersensitivity. Studies on cell cultures and animal models
have shown that long-term antipsychotic use is linked to both an upregulation of
dopamine D2-receptors in the striatum and the emergence of enhanced receptor
affinity to endogenous dopamine. These findings have been hypothesized to
contribute to the phenomenon known as dopamine supersensitivity psychosis (DSP),
which has been clinically typified as the foundation of rebound psychosis, drug tolerance, and tardive
dyskinesia. The focus of this review is the update of evidence behind the classification of antipsychotic
induced DSP and an investigation of its relationship to treatment resistance. Since antipsychotics are the
foundation of illness management, a greater understanding of DSP and its prevention may greatly affect
patient outcomes.
