Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis

Ueda, Satoshi; Sakayori, Takeshi; Omori, Ataru; Fukuta, Hajime; Kobayashi, Takashi; Ishizaka, Kousuke; Saijo, Tomoyuki; Okubo, Yoshiro

doi:10.2147/ndt.s99577

Cited by 6 publications

(7 citation statements)

References 7 publications

(11 reference statements)

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“…The search strategy resulted in a total of 9 articles that met the inclusion criteria and were thus included in this review, informing data from a total of 1282 BD subjects. Four reports included only BD subjects (6,46,49,50), three explored compliance (6,33,49) and only three had a prospective design (6,29,49). Given the nature of the found data, it was not possible to perform a quantitative analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Ueda et al [50] reported a series of three clinical vignettes on which neuroleptic deficit syndrome (NIDS) was superimposed with a depressive episode in BD patients treated with second-generation AP. In these cases, the NIDS included apathy, lack of initiative, emotional blunting, indifference and, more interestingly, poor insight into disease with a reduced desire to improve.…”

Section: Resultsmentioning

confidence: 99%

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Subjective response to antipsychotics in bipolar disorders: A review of a neglected area

Strejilevich¹,

Camino²,

Caravotta³

et al. 2019

Eur. psychiatr.

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Background: The term “subjective response to antipsychotic” (SRA) refers to changes in the subjective state experienced due to antipsychotic (AP) exposition that is independent of the therapeutic or physical side effects of these drugs. This dimension of analysis has been extensively explored in schizophrenic disorders, finding that negative SRA is an early and independent predictor of compliance as well as a successful pathway to construct current theoretical frameworks of these disorders. There is an increasing use of AP in bipolar disorders’ treatment (BD) but no reviews on the topic have been published to date in this population. The aim of this work is to review published data of SRA in BD patients and to discuss their clinical and theoretical implications. Methods: An extensive search in online databases was performed. Reports were reviewed and included if they described SRA in BD or included instruments aimed to assess it. Reports of cognitive, sexual, motor autonomic side effects were excluded. Findings were summarized in a narrative fashion. Results: Nine reports fulfilled the inclusion criteria and were included in the revision, reporting data from 1282 BD patients. Among these, three were prospective studies and three explored relations between SRA and treatment compliance. Conclusions: There is an asymmetry between the increase in the use of antipsychotics in BD and the lack of data regarding the SRA. Phenomenologically, SRA in BD is similar to that found in schizophrenic subjects. Some of these symptoms may be misdiagnosed as depressive symptoms. The existing data show that SRA has a strong correlation with treatment compliance as well as a promising way to develop theoretical paradigms for these disorders.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Subjective response to antipsychotics in bipolar disorders: A review of a neglected area

Strejilevich¹,

Camino²,

Caravotta³

et al. 2019

Eur. psychiatr.

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“…Australian & New Zealand Journal of Psychiatry,56(5) indifference, apathy, amotivation anhedonia and blunted affect (Ueda et al, 2016). NIDS may be considered associated with, or analogous to, what others have termed 'tardive dysmentia' -a state of affective blunting, reduced activation and diminished interpersonal activity (Wilson et al, 1983).…”

Section: Introductionmentioning

confidence: 99%

“…In the nigrostriatal pathway, we may see TD – that is, persistent, repetitive, abnormal involuntary movements, often of the lips and tongue (Teo et al, 2012). In the mesocortical pathway we may see ‘neuroleptic-induced deficit syndrome’ (NIDS) – a state of emotional indifference, apathy, amotivation anhedonia and blunted affect (Ueda et al, 2016). NIDS may be considered associated with, or analogous to, what others have termed ‘tardive dysmentia’ – a state of affective blunting, reduced activation and diminished interpersonal activity (Wilson et al, 1983).…”

Section: Introductionmentioning

confidence: 99%

Antipsychotic-induced supersensitivity – A reappraisal

Lugg

2021

Aust N Z J Psychiatry

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Objectives: Tardive dyskinesia, psychotic relapse and treatment-refractory psychosis have long been associated. A common underlying mechanism involving antipsychotic-induced ‘supersensitivity’, albeit in different brain pathways, was proposed as early as 1978. This piece seeks to reappraise the concept and potential implications of antipsychotic-induced supersensitivity. Conclusions: Evidence increasingly suggests that chronic antipsychotic exposure induces neuroadaptive physiological changes in dopaminergic, and other, neurotransmitter systems that may render some individuals more vulnerable to psychotic relapse - including those receiving continuous antipsychotic treatment. It is possible that in treating every episode of psychosis with prolonged or indefinite antipsychotic therapy, we paradoxically increase the risk of psychotic relapse in a significant proportion of people. A greater appreciation of supersensitivity may allow us to optimise any potential benefits of antipsychotics while minimising the risk of inadvertent iatrogenic harms. More research is needed to improve our understanding of the underlying neurophysiology of supersensitivity and to better identify which individuals are most vulnerable to its development. It is time we paid more attention to the concept, emerging evidence and potential implications of antipsychotic-induced supersensitivity and, where appropriate, adjusted our practice accordingly.

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“…Although antipsychotics are usually first choice among drugs in psychosis, they are often insufficient [72]. Moreover, they may induce an “anti-joy-of-life” effect [73] or deficit syndrome resembling negative symptoms [74], and in the long run carry the risks of tardive psychosis [22, 75] and lower functional remission rate [76, 77]. Antidepressants may reduce negative symptoms [78] and suicide in schizophrenia [79, 80], and in one study reduced transition to psychosis in high-risk subjects more than antipsychotics [81], consistent with psychotic experiences being a marker foremost of affective dysregulation [82].…”

Section: Introductionmentioning

confidence: 99%

Is schizophrenia disappearing? The rise and fall of the diagnosis of functional psychoses: an essay

Bergsholm

2016

BMC Psychiatry

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BackgroundThe categories of functional psychoses build on views of influential professionals. There have long been four main categories – affective, schizophrenic, schizoaffective/cycloid/reactive/polymorphic, and delusional/paranoid psychoses. The last three are included in “psychotic disorders”. However, this dichotomy and the distinctions between categories may have been over-estimated and contributed to lack of progress.Ten topics relevant for the diagnosis of functional psychoses1. The categories of functional psychoses have varied with time, place and professionals’ views, with moving boundaries, especially between schizophrenia and affective psychoses. 2. Catatonia is most often related to affective and organic psychoses, and paranoia is related to grandiosity and guilt, calling in question catatonic and paranoid schizophrenia. Arguments exist for schizophrenia being a “misdiagnosis”. 3. In some countries schizophrenia has been renamed, with positive consequences. 4. The doctrine of “unitary psychosis”, which included abnormal affect, was left in the second half of the 1800s. 5. This was followed by a dichotomy between schizophrenia and affective psychoses and broadening of the schizophrenia concept, whereas affective symptoms were strongly downgraded. 6. Many homogeneous psychoses with mixtures of schizophrenic and affective symptoms were described and related to “psychotic disorders”, although they might as well be affective disorders. 7. Critique of the extensive schizophrenia concept led to, in DSM-III and ICD-10, affective symptoms being exclusion criteria for schizophrenia and acceptance of mood-incongruent psychotic symptoms in affective psychoses. 8. However, affective symptoms are often difficult to acknowledge, diagnosis is often done on the basis of tradition and previous education, and patients’ affect characterized accordingly. 9. DSM-5 is up-dated with separate chapters for catatonia and psychotic symptoms, and removal of the subtypes of schizophrenia. However, time may be running out for categorical psychosis diagnoses, which may be replaced by continuum, spectrum, dimensional and research domain criteria, in line with new biological data 10. This is supported by treatment responses across categories.ConclusionThe time-consuming works on diagnosis of psychoses may have hampered progress. Chronic mood disorders may appear as schizophrenic or paranoid psychosis, end-stages like heart failure in heart diseases. This underscores the importance of early and optimal treatment of mood disorders.

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Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis

Cited by 6 publications

References 7 publications

Subjective response to antipsychotics in bipolar disorders: A review of a neglected area

Subjective response to antipsychotics in bipolar disorders: A review of a neglected area

Antipsychotic-induced supersensitivity – A reappraisal

Is schizophrenia disappearing? The rise and fall of the diagnosis of functional psychoses: an essay

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