Skip to main content
SpringerLink
Log in

New Clinical Concepts on Neuroleptic-Induced Supersensitivity Disorders: Tardive Dyskinesia and Supersensitivity Psychosis

  • Chapter
Guidelines for the Use of Psychotropic Drugs

Abstract

The use of antipsychotic drugs in the management of schizophrenia became widespread as no other equally effective treatment existed. Although these drugs appeared safe at the beginning, it was soon discovered that their long-term side effects were associated with the central nervous system. First, tardive dyskinesia (Shonecker, 1957; Faurbye et al., 1964) and then supersensitivity psychosis (Chouinard, Jones and Annable, 1978; Chouinard and Jones, 1980) were recognized following prolonged neuroleptic administration. Several theories have been proposed for these long-term side effects. The dopamine theory, which attributes them to postsynaptic dopamine receptor supersensitivity (Klawans, 1980) best explains clinical findings. Withdrawal of neuroleptics after prolonged blockade results in a release of dopamine with manifest supersensitivity symptoms, while neuroleptic reinstitution has a masking effect.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Agnati, L.F., Fuxe, K., Andersson, F., Benfenati, P., Cortelli, D’Alessandro, R. The mesolimbic dopamine system: evidence for high amine turnover and for a heterogeneity of the dopamine neuron population. Neurosci. Lett. 18: 45–51, 1980.

    Article  PubMed  CAS  Google Scholar 

  • Alpert, M., and Friedhoff, A.J. Receptor sensitivity modification in the treatment of tardive dyskinesia. Clin. Pharmacol. Ther. 19: 103, 1976.

    Google Scholar 

  • Asnis, G.M., Leopold, M.A., Duvoisin, R.C. Schwartz, A.H. A survey of tardive dyskinesia in psychiatric outpatients. Am. J. Psychiatry 134: 1367–1370, 1977.

    PubMed  CAS  Google Scholar 

  • Asper, H., Baggraline, M., Burki, H.R. et al. Tolerance phenomena with neuroleptics: catalepsy, apomorphine stereotypes and striatal dopamine metabolism in the rat after single and repeated administration of loxapine and haloperidol. Eur. J. Pharmacol. 22: 287–294, 1973.

    Article  PubMed  CAS  Google Scholar 

  • Bell, R.C.H., and Smith, R.C. Tardive dyskinesia: characterization and preva- lence in a statewide system. J. Clin. Psychiatry 39: 39–42, 46–47, 1978.

    Google Scholar 

  • Capstick, N. Long-term fluphenazine decanoate maintenance dosage requirements of chronic schizophrenic patient. Acta. Psychiat. Scand. 61: 256–262, 1980.

    Article  PubMed  CAS  Google Scholar 

  • Carey, R., and DeVeaugh-Geiss, J. Chronic benztropine and haloperidol administration induce behaviorably equivalent pharmacological hypersensitivities separately but not in combination. Psychopharmacology 76: 341–345, 1982.

    Article  PubMed  CAS  Google Scholar 

  • Chouinard, G. Neuroleptic-induced supersensitivity psychosis. In: DeVeaugh-Geiss, J., Ed. Tardive Dyskinesia and Related Involuntary Movement Disorders. John Wright PSG of Boston, Massachusetts, 1982, pp. 109–115.

    Google Scholar 

  • Chouinard, G., and Annable, L. Penfluridol in the treatment of newly admitted schizophrenic patients in a brief therapy unit. Am. J. Psychiatry 133: 820–823, 1976.

    Google Scholar 

  • Chouinard, G., and Annable, L. Pimozide in the treatment of newly admitted schizophrenic patients. Psychopharmacology 76: 13–19, 1982.

    Article  PubMed  CAS  Google Scholar 

  • Chouinard, G., Annable, L., and Denis, J.F. Fluspirilene in the treatment of acute schizophrenia. Scientific Proceedings of the 30th Annual Meeting of the Canadian Psychiatric Association, Toronto, Ontario, No. 86, pp. 77–78, 1980.

    Google Scholar 

  • Chouinard, G., Annable, L., Jones, B.D. L-dopa in drug-induced extrapyramidal symptoms. Synopsis, 12th C.I.N.P. Congress (Collegium Internationale Neuropsychopharmacologicum), G.teborg, Sweden, p. 106, 1980.

    Google Scholar 

  • Chouinard, G., Annable, L., Jones, B.D., Ross-Chouinard, A. Sex differences and tardive dyskinesia. Am. J. Psychiatry 137: 507, 1980.

    PubMed  CAS  Google Scholar 

  • Chouinard, G., Annable, L., Ross-Chouinard, A. Comparison of fluphenazine esters in the treatment of schizophrenic outpatients: extrapyramidal symptoms and therapeutic effect. Am. J. Psychiatry 139: 312–318, 1982.

    PubMed  CAS  Google Scholar 

  • Chouinard, G., Annable, L., Ross-Chouinard, A., Kropsky, M. Ethopropazine and benztropine in neuroleptic-induced parkinsonism. J. Clin. Psychiatry 40: 147–152, 1979a.

    PubMed  CAS  Google Scholar 

  • Chouinard, G., Annable, L., Ross-Chouinard, A. Nestoros, J. Factors related to tardive dyskinesia. Am. J. Psychiatry 136: 79–83, 1979b.

    PubMed  CAS  Google Scholar 

  • Chouinard, G., Bradwejn, J. Reversible and irreversible tardive dyskinesia. Am. J. Psychiatry 139: 360–362, 1982.

    PubMed  CAS  Google Scholar 

  • Chouinard, G., De Montigny, C., and Annable, L. Tardive dyskinesia and antiparkinsonian medications. Am. J. Psychiatry 136: 228–229, 1979.

    PubMed  CAS  Google Scholar 

  • Chouinard, G., and Jones, B.D. Schizophrenia as dopamine-deficiency disease. Lancet 2: 99–100, 1978.

    Article  PubMed  CAS  Google Scholar 

  • Chouinard, G., and Jones, B.D. Neuroleptic-induced supersensitivity psychosis: clinical and pharmacologic characteristics. Am. J. Psychiatry 137: 16–21, 1980.

    PubMed  CAS  Google Scholar 

  • Chouinard, G., and Jones, B.D. Neuroleptic-induced supersensitivity psychosis, the hump course and tardive dyskinesia. J. Clin. Psychopharmacol. 2: 143–144, 1982.

    Google Scholar 

  • Chouinard, G., Jones, B.D., and Annable, L. Neuroleptic-induced supersensitivity psychosis. Am. J. Psychiatry 135: 1409–1410, 1978.

    PubMed  CAS  Google Scholar 

  • Christensen, A.V., and Nielsen, I.M. Dopaminergic supersensitivity: influence of dopamine agonists, cholinergics, anticholinergics, and drugs used for the treatment of tardive dyskinesia. Psychopharmacology 62: 111–116, 1979.

    Article  PubMed  CAS  Google Scholar 

  • Crane, G.E. Dyskinesia and neuroleptics. Arch. Gen. Psychiatry 19: 700–703, 1968.

    Article  PubMed  CAS  Google Scholar 

  • Crane, G.E. Persistent dyskinesia. Br. J. Psychiatry 122: 395–405, 1973.

    Article  PubMed  CAS  Google Scholar 

  • Ekholm, B., Eriksson, H., and Lindstrom, L. Tardive psychosis: hypothesis or reality. Lakartidninger 78: 1–5, 1981.

    Google Scholar 

  • Engel, J., and Liljequest, S. The effect of long-term ethanol treatment on the sensitivity of dopamine receptors in the nucleus accumbus. Psychopharmacology 49: 247–253, 1976.

    Article  Google Scholar 

  • Ezrin-Waters, C., and Seeman, P. L-dopa reversal of hyperdopaminergic behavior. Life Sci. 22: 1027–1032, 1978.

    Article  PubMed  CAS  Google Scholar 

  • Ezrin-Waters, C., Seeman, M.V., and Seeman, P. Tardive dyskinesia in schizophrenic outpatients: prevalence and significant variables. J. Clin. Psychiatry 42: 16–22, 1981.

    PubMed  CAS  Google Scholar 

  • Fann, W.E., Davis, J.M., and Janowsky, D.S. The prevalence of tardive dys- kinesias in mental hospital patients. Dis. Nerv. Syst. 33: 182–186, 1972.

    PubMed  CAS  Google Scholar 

  • Faurbye, A., Rasch, P.J., Petersen, P.B. Brandborg, G., and Pakkenberg, H. Neurological symptoms in pharmacotherapy of psychoses. Acta. Psychiatr. Scand. 40: 10–27, 1964.

    Article  PubMed  CAS  Google Scholar 

  • Fields, J., and Gordon, J. Estrogen inhibits supersensitivity induced by neuroleptics. Life Sci. 3: 229–234, 1982.

    Article  Google Scholar 

  • Gardos, G., Cole, J.O., and La Brie, R.A. Drug variables in the etiology of tardive dyskinesia application of discriminant function analysis. Prog. Neuropsychopharmacol. 1: 147–154, 1977.

    Article  PubMed  CAS  Google Scholar 

  • Gardos, G., Samu, I., Kallos, M., and Cole, J.O. Absence of severe tardive dyskinesia in Hungarian schizophrenic out-patients. Psychopharmacology 71: 29–34, 1980.

    Article  PubMed  CAS  Google Scholar 

  • Gerlach, J., and Luhdorf, K. The effect of L-dopa on young patients with simple schizophrenia, treated with neuroleptic drugs. Psychopharmacology 44: 105–110, 1975.

    Article  CAS  Google Scholar 

  • Gibson, A.C. Depot injections and tardive dyskinesia. Br. J. Psychiatry 132: 361–365, 1978.

    Article  Google Scholar 

  • Glick, I., and Steward, D. A new drug treatment for premenstrual exacerbation of schizophrenia. Compr. Psychiatry 21: 281–287, 1980.

    Article  PubMed  CAS  Google Scholar 

  • Hollister, L.E. Drugs for schizophrenia. Rational Drug Therapy 16 (8): 1–6, 1982.

    Google Scholar 

  • Inanaga, K., Inoue, K., Tachibana, H., Oshima, M., and Kotorii, T. Effect of L-dopa in schizophrenia. Folia Psychiatr. Neurol. Jpn. 26: 145–157, 1972.

    PubMed  CAS  Google Scholar 

  • Jeste, D.V., Olgiati, S.G., and Chali, A.Y. Masking of tardive dyskinesia with four times-a-day administration of chlorpromazine. Dis. Nerv. Syst. 38: 755–758, 1977.

    PubMed  CAS  Google Scholar 

  • Jeste, D.V., Potkim, S.G., Sinha, S., Feder, S., and Wyatt, R.J. Tardive dyskinesia—reversible and persistent. Arch. Gen. Psychiatry 36: 1080–1082, 1979.

    Article  Google Scholar 

  • Jus, A., Pineau, R., Lachance, R., Pelchat, G., Jus, K., Pires, P., and Villeneuve, R. Epidemiology of tardive dyskinesia, Part I. Dis. Nerv. Syste. 37: 210–214, 1976.

    Google Scholar 

  • Klawans, H.L. The pharmacology of tardive dyskinesia. Am. J. Psychiatry 130: 82–86, 1973.

    PubMed  Google Scholar 

  • Kucharski, L.T., Smith, J.M., and Dunn, D.D. Tardive dyskinesia and hospital discharge. J. Nerv. Ment. Dis. 168: 215–218, 1980.

    Article  PubMed  CAS  Google Scholar 

  • Lai, H., Makous, W.L., Houta, A., and Lenog, H. Effects of ethanol on turnover and function of striatal dopamine. Psychopharmacology 61: 1–9, 1979.

    Article  PubMed  CAS  Google Scholar 

  • Moller, N.I., Fayalland, B., Pedersen, V. et al. Pharmacology of neuroleptics upon repeated administration. Psychopharmacologia (Berl) 34: 95–104, 1974.

    Article  Google Scholar 

  • Mukherjee, S., Rosen, A.M., Cardenas, C., Varia, V., and Olarte, S. Tardive dyskinesia in psychiatric outpatients. Arch. Gen. Psychiatry 39: 466–469, 1982.

    Article  PubMed  CAS  Google Scholar 

  • Owen, F., Cross, A.J., Crow, T.J. et al. Increased dopamine receptor sensitivity in schizophrenia. Lancet 2: 223–226, 1979.

    Google Scholar 

  • Quitkin, F., Rifkin, A., Gochfeld, L., et al. Tardive dyskinesia: are first signs reversible ? Am. J. Psychiatry 134: 84–87, 1977.

    PubMed  CAS  Google Scholar 

  • Raymond, V., Beaulieu, M., Labrie, F., and Boissier, J. Potent antidopaminergic activity of estradiol at the pituitary level on prolactin release. Science 200: 1173–1175, 1978.

    Article  PubMed  CAS  Google Scholar 

  • Schonecker, M. Ein eigentumliches syndrom im oralen bereich bei megaphen applikation. Nervenarzt 28: 35, 1957.

    Google Scholar 

  • Seeger, T., and Gardner, E. Enhancement of self-stimulation in rats and monkeys after chronic neuroleptic treatment: evidence for mesolimbic supersensitivity. Brain Res. 175: 49–57, 1979.

    Article  PubMed  CAS  Google Scholar 

  • Simpson, G.M., Varga, E., Lee, J.H., and Zoubok, B. Tardive dyskinesia and psychotropic drug history. Psychopharmacology 58: 117–124, 1978.

    Article  PubMed  CAS  Google Scholar 

  • Smith, J.M. Abuse of the antiparkinson drugs: a review of the literature. J. Clin. Psychiatry 41: 351–354, 1980.

    PubMed  CAS  Google Scholar 

  • Smith, J.M., and Baldessarini, R.J. Changes in prevalence, severity, and recovery in tardive dyskinesia with age. Arch. Gen. Psychiatry 37: 1368–1373, 1980.

    Article  PubMed  CAS  Google Scholar 

  • Smith, J.M., and Dunn, D.D. Sex differences in the prevalence of severe tardive dyskinesia. Am. J. Psychiatry 136: 1080–1082, 1979.

    PubMed  CAS  Google Scholar 

  • Smith, J.M., Kucharski, L.T., Eblen, C., Knutsen, E., and Linn, C. An assessment of tardive dyskinesia in schizophrenic outpatients. Psychopharmacology 64: 99–104, 1979.

    Article  PubMed  CAS  Google Scholar 

  • Smith, R.C., and Lucavathi, D.E. Behavioral and biochemical effects of chronic neuroleptic drugs: interaction with age. In: W.E. Fann, R.C. Smith, J.M. Davis, et al., Eds. Tardive Dyskinesia: Research and Treatment. Spectrum Publications, Jamaica, N.Y., 1980, pp. 65–88.

    Chapter  Google Scholar 

  • Smith, R.C., Strizich, M., and Klass, D. Drug history and tardive dyskinesia. Am. J. Psychiatry 135: 1402–1403, 1978.

    PubMed  CAS  Google Scholar 

  • Staton, D., and Brumback, R. Neuroleptic-induced reinnervation sprouting in the central nervous system. J. Clin. Psychiatry 41: 427–428, 1980.

    PubMed  CAS  Google Scholar 

  • Veith, K. Comparison of behavioral supersensitivity to apomorphine after fluphenazine dehydrochloride and fluphenazine decanoate treatment in rats. Prog. Neuropsychopharmacol. 1: 289–295, 1977.

    Article  Google Scholar 

  • Villeneuve, A., Czaejust, T., and Cote, M. Neuropsychobiology 6: 145–151, 1980.

    Article  PubMed  CAS  Google Scholar 

  • Waddington, J., and Gamble, S. Neuroleptic treatment for a substantial proportion of adult life: behavioral suquelae of 9 months haloperidol administration. Eur. J. Pharmacol. 67: 363–369, 1980.

    Article  PubMed  CAS  Google Scholar 

  • Walters, J.R., and Roth, R.H. Dopaminergic neurons: an in vivo system for measuring drug interactions with presynaptic receptors. Arch. Pharmacol. 296: 5–14, 1976.

    Article  CAS  Google Scholar 

  • Yaryura-Tobias, J.A., Wolpert, A., Dana, L., and Merlis, S. The action of L-dopa on schizophrenic patients. Curr. Ther. Res. 12: 528–531, 1970.

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. Guy Chouinard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susanne Steinberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Clarke Institute of Psychiatry, University of Toronto, Canada

    Harvey C. Stancer Ph.D., M.D., F.R.C.P.(C)  & Vivian M. Rakoff M.A., M.B., F.R.C.P.(C)  & 

  2. Toronto General Hospital, University of Toronto, Canada

    Paul E. Garfinkel M.S., M.D., F.R.C.P.(C)

Rights and permissions

Reprints and permissions

Copyright information

© 1984 Spectrum Publications, Inc.

About this chapter

Cite this chapter

Chouinard, G., Steinberg, S. (1984). New Clinical Concepts on Neuroleptic-Induced Supersensitivity Disorders: Tardive Dyskinesia and Supersensitivity Psychosis. In: Stancer, H.C., Garfinkel, P.E., Rakoff, V.M. (eds) Guidelines for the Use of Psychotropic Drugs. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-7618-7_13

Download citation

  • DOI: https://doi.org/10.1007/978-94-011-7618-7_13

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-011-7620-0

  • Online ISBN: 978-94-011-7618-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation