Article ; Online: Suicidality and psychotic episodes after starting aripiprazole: two case reports.
International clinical psychopharmacology
2022 Volume 37, Issue 5, Page(s) 225–228
Abstract: Switching antipsychotic medication must be done carefully to ensure patient safety and a successful response. Here, we present two major psychotic decompensations that occurred following a switch to aripiprazole in two patients with schizophrenia. Mr. X ... ...
| Abstract | Switching antipsychotic medication must be done carefully to ensure patient safety and a successful response. Here, we present two major psychotic decompensations that occurred following a switch to aripiprazole in two patients with schizophrenia. Mr. X was treated with paliperidone and experienced residual anxiety. Thus, a switch to aripiprazole was planned with risperidone and a gradual decrease in paliperidone. Initially, an increase in aripiprazole resulted in remission of his residual symptoms. However, two weeks later, he presented an anxiety relapse with persecutory ideas which required hospitalization. Mr. Y, who was treated for many years with risperidone, presented with a treatment resistant psychotic episode. A switch to aripiprazole enhanced his clinical condition. Despite the initial improvement, soon after discharge from the hospital, the patient presented psychotic symptoms requiring home intervention. Ultimately, the patient in the midst of a delusional recrudescence, had killed himself when the health care team arrived. A strong dopamine antagonist may lead to the development of dopaminergic upregulation. The addition of a partial agonist to these hypersensitive neurotransmitter pathways could explain these episodes. We agree with previous reports and recommend careful management when switching from strong dopamine antagonists to aripiprazole. |
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| MeSH term(s) | Antipsychotic Agents/adverse effects ; Aripiprazole/adverse effects ; Humans ; Male ; Paliperidone Palmitate ; Risperidone/adverse effects ; Suicide |
| Chemical Substances | Antipsychotic Agents ; Aripiprazole (82VFR53I78) ; Risperidone (L6UH7ZF8HC) ; Paliperidone Palmitate (R8P8USM8FR) |
| Language | English |
| Publishing date | 2022-06-02 |
| Publishing country | England |
| Document type | Case Reports ; Journal Article |
| ZDB-ID | 632837-4 |
| ISSN | 1473-5857 ; 0268-1315 |
| ISSN (online) | 1473-5857 |
| ISSN | 0268-1315 |
| DOI | 10.1097/YIC.0000000000000408 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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