长期氯氮平治疗和难治性精神分裂症患者加用卡吡嗪治疗:精神恶化和比萨综合征2例

IF 2.4 4区医学 Q3 NEUROSCIENCES

Clinical Psychopharmacology and Neuroscience Pub Date : 2022-05-31 DOI:10.9758/cpn.2022.20.2.398

Judith Weise, G. Schomerus, S. Speerforck

{"title":"长期氯氮平治疗和难治性精神分裂症患者加用卡吡嗪治疗:精神恶化和比萨综合征2例","authors":"Judith Weise, G. Schomerus, S. Speerforck","doi":"10.9758/cpn.2022.20.2.398","DOIUrl":null,"url":null,"abstract":"An increasing number of studies deal with medical options for treatment resistant schizophrenia. If no remission can be achieved with clozapine, a combination of antipsychotics can be considered. The combination of clozapine and cariprazine is rarely studied. Cariprazine is a partial agonist on dopamine D2 and D3 receptors and a pharmaceutically rational add-on to clozapine. Stimulating D3 receptors has been linked to improved cognition and mood, with negligible extrapyramidal side effects. We present two patients with long-term treatment resistant schizophrenia receiving cariprazine and clozapine. Whereas psychotic symptoms worsened, the patients developed extrapyramidal side effects with a Pisa syndrome. The syndrome remitted after discontinuation of cariprazine. Possible explanations by pharmacodynamic interactions and drug specific receptor profiles are discussed.","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"20 1","pages":"398 - 401"},"PeriodicalIF":2.4000,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"9","resultStr":"{\"title\":\"Add-on Cariprazine in Patients with Long-term Clozapine Treatment and Treatment Resistant Schizophrenia: Two Cases of Psychotic Deterioration and Pisa Syndrome\",\"authors\":\"Judith Weise, G. Schomerus, S. Speerforck\",\"doi\":\"10.9758/cpn.2022.20.2.398\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"An increasing number of studies deal with medical options for treatment resistant schizophrenia. If no remission can be achieved with clozapine, a combination of antipsychotics can be considered. The combination of clozapine and cariprazine is rarely studied. Cariprazine is a partial agonist on dopamine D2 and D3 receptors and a pharmaceutically rational add-on to clozapine. Stimulating D3 receptors has been linked to improved cognition and mood, with negligible extrapyramidal side effects. We present two patients with long-term treatment resistant schizophrenia receiving cariprazine and clozapine. Whereas psychotic symptoms worsened, the patients developed extrapyramidal side effects with a Pisa syndrome. The syndrome remitted after discontinuation of cariprazine. Possible explanations by pharmacodynamic interactions and drug specific receptor profiles are discussed.\",\"PeriodicalId\":10420,\"journal\":{\"name\":\"Clinical Psychopharmacology and Neuroscience\",\"volume\":\"20 1\",\"pages\":\"398 - 401\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2022-05-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"9\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Psychopharmacology and Neuroscience\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.9758/cpn.2022.20.2.398\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Psychopharmacology and Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.9758/cpn.2022.20.2.398","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 9

摘要

越来越多的研究涉及治疗难治性精神分裂症的医学选择。如果氯氮平不能缓解，可以考虑联合使用抗精神病药物。氯氮平与卡吡嗪合用的研究很少。卡吡嗪是多巴胺D2和D3受体的部分激动剂，是氯氮平的合理药物补充物。刺激D3受体与改善认知和情绪有关，而锥体外系副作用可以忽略不计。我们报告了两例长期治疗难治性精神分裂症患者接受卡吡嗪和氯氮平。而精神病症状恶化，患者出现锥体外系副作用与比萨综合征。停用卡吡嗪后症状缓解。讨论了药效学相互作用和药物特异性受体谱的可能解释。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Add-on Cariprazine in Patients with Long-term Clozapine Treatment and Treatment Resistant Schizophrenia: Two Cases of Psychotic Deterioration and Pisa Syndrome

An increasing number of studies deal with medical options for treatment resistant schizophrenia. If no remission can be achieved with clozapine, a combination of antipsychotics can be considered. The combination of clozapine and cariprazine is rarely studied. Cariprazine is a partial agonist on dopamine D2 and D3 receptors and a pharmaceutically rational add-on to clozapine. Stimulating D3 receptors has been linked to improved cognition and mood, with negligible extrapyramidal side effects. We present two patients with long-term treatment resistant schizophrenia receiving cariprazine and clozapine. Whereas psychotic symptoms worsened, the patients developed extrapyramidal side effects with a Pisa syndrome. The syndrome remitted after discontinuation of cariprazine. Possible explanations by pharmacodynamic interactions and drug specific receptor profiles are discussed.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Clinical Psychopharmacology and Neuroscience NEUROSCIENCESPHARMACOLOGY & PHARMACY-PHARMACOLOGY & PHARMACY

CiteScore

4.70

自引率

12.50%

发文量

期刊介绍： Clinical Psychopharmacology and Neuroscience (Clin Psychopharmacol Neurosci) launched in 2003, is the official journal of The Korean College of Neuropsychopharmacology (KCNP), and the associate journal for Asian College of Neuropsychopharmacology (AsCNP). This journal aims to publish evidence-based, scientifically written articles related to clinical and preclinical studies in the field of psychopharmacology and neuroscience. This journal intends to foster and encourage communications between psychiatrist, neuroscientist and all related experts in Asia as well as worldwide. It is published four times a year at the last day of February, May, August, and November.