Neuroleptic-induced deficit syndrome: Difference between revisions
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'''Neuroleptic-induced deficit syndrome''' ('''NIDS''') is a psychopathological syndrome that develops in some patients who take high doses of an [[antipsychotic]] for an extended time.<ref>{{cite journal | title=Neuroleptic |
'''Neuroleptic-induced deficit syndrome''' ('''NIDS''') is a psychopathological syndrome that develops in some patients who take high doses of an [[antipsychotic]] for an extended time.<ref>{{cite journal |author-last1=Lader |author-first1=Malcolm Harold | title=Neuroleptic-Induced Deficit Syndrome (NIDS) | pmid=7903967 | volume=54 | journal=[[Journal of Clinical Psychiatry]] | pages=493–500}}</ref> It is most often caused by high-potency [[typical antipsychotic]]s, but can also be caused by high doses of many [[Atypical antipsychotic|atypicals]], especially those closer in profile to typical ones (that have higher [[Dopamine receptor D2|D<sub>2</sub> dopamine receptor]] affinity and relatively low [[5-HT2 receptor|5-HT<sub>2</sub> serotonin receptor]] binding affinity), like [[paliperidone]] and [[amisulpride]].<ref name="Ueda">{{cite journal|vauthors=Ueda S, Sakayori T, Omori A, Fukuta H, Kobayashi T, Ishizaka K, etal| title=Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis. | journal=Neuropsychiatr Dis Treat | year= 2016 | volume= 12 | pages= 265–268 | pmid=26893564 | doi=10.2147/NDT.S99577 | pmc=4745952}}</ref> |
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== Symptoms == |
== Symptoms == |
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Neuroleptic |
Neuroleptic-induced deficit syndrome is principally characterized by the same symptoms that constitute the negative symptoms of [[schizophrenia]]: [[Reduced affect display|emotional blunting]], [[apathy]], [[hypobulia]], [[anhedonia]], indifference, difficulty or total inability in thinking, difficulty or total inability in concentrating, lack of [[initiative]], attention deficits, and desocialization.<ref name="Ueda"/> This can easily lead to misdiagnosis and mistreatment. Instead of decreasing the antipsychotic, the doctor may increase their dose to try to "improve" what they perceive to be negative symptoms of schizophrenia, rather than antipsychotic side effects.{{citation needed|date=February 2013}} The concept of neuroleptic-induced deficit syndrome was initially presented for [[schizophrenia]], and it has rarely been associated in other mental disorders.<ref name="Ueda"/> In recent years, atypical neuroleptics are being more often managed to patients with [[bipolar disorder]], so some studies about neuroleptic-induced deficit syndrome in bipolar disorder patients are now available.<ref name="Ueda"/> |
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There are significant difficulties in the differential diagnosis of primary negative symptoms and neuroleptic deficiency syndrome (secondary negative symptoms), as well as [[Major depressive disorder|depression]].<ref name="Barnes-McPhillips">{{cite journal|vauthors=Barnes TR, McPhillips MA | title=How to distinguish between the neuroleptic-induced deficit syndrome, depression and disease-related negative symptoms in schizophrenia. | journal=Int Clin Psychopharmacol | year= 1995 | volume= 10 Suppl 3 | pages= 115–121 | pmid=8866773 | doi=10.1097/00004850-199509000-00015}}</ref> |
There are significant difficulties in the differential diagnosis of primary negative symptoms and neuroleptic deficiency syndrome (secondary negative symptoms), as well as [[Major depressive disorder|depression]].<ref name="Barnes-McPhillips">{{cite journal|vauthors=Barnes TR, McPhillips MA | title=How to distinguish between the neuroleptic-induced deficit syndrome, depression and disease-related negative symptoms in schizophrenia. | journal=Int Clin Psychopharmacol | year= 1995 | volume= 10 Suppl 3 | pages= 115–121 | pmid=8866773 | doi=10.1097/00004850-199509000-00015}}</ref> |
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[[Category:Adverse effects of psychoactive drugs]] |
[[Category:Adverse effects of psychoactive drugs]] |
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[[Category:Antipsychotics]] |
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[[Category:Psychopathological syndromes]] |
[[Category:Psychopathological syndromes]] |
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Revision as of 04:23, 26 March 2021
Neuroleptic-induced deficit syndrome (NIDS) is a psychopathological syndrome that develops in some patients who take high doses of an antipsychotic for an extended time.[1] It is most often caused by high-potency typical antipsychotics, but can also be caused by high doses of many atypicals, especially those closer in profile to typical ones (that have higher D2 dopamine receptor affinity and relatively low 5-HT2 serotonin receptor binding affinity), like paliperidone and amisulpride.[2]
Symptoms
Neuroleptic-induced deficit syndrome is principally characterized by the same symptoms that constitute the negative symptoms of schizophrenia: emotional blunting, apathy, hypobulia, anhedonia, indifference, difficulty or total inability in thinking, difficulty or total inability in concentrating, lack of initiative, attention deficits, and desocialization.[2] This can easily lead to misdiagnosis and mistreatment. Instead of decreasing the antipsychotic, the doctor may increase their dose to try to "improve" what they perceive to be negative symptoms of schizophrenia, rather than antipsychotic side effects.[citation needed] The concept of neuroleptic-induced deficit syndrome was initially presented for schizophrenia, and it has rarely been associated in other mental disorders.[2] In recent years, atypical neuroleptics are being more often managed to patients with bipolar disorder, so some studies about neuroleptic-induced deficit syndrome in bipolar disorder patients are now available.[2]
There are significant difficulties in the differential diagnosis of primary negative symptoms and neuroleptic deficiency syndrome (secondary negative symptoms), as well as depression.[3]
Case
A Japanese man, who was being treated for schizophrenia, exhibited neuroleptics-induced deficit syndrome and obsessive–compulsive symptoms.[4] His symptoms were remarkably improved by quitting a course of antipsychotics followed by the introduction of the antidepressant fluvoxamine.[4] He had been misdiagnosed with schizophrenia, the real diagnosis was obsessive–compulsive disorder.[4]
References
- ^ Lader, Malcolm Harold. "Neuroleptic-Induced Deficit Syndrome (NIDS)". Journal of Clinical Psychiatry. 54: 493–500. PMID 7903967.
- ^ a b c d Ueda S, Sakayori T, Omori A, Fukuta H, Kobayashi T, Ishizaka K, et al. (2016). "Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis". Neuropsychiatr Dis Treat. 12: 265–268. doi:10.2147/NDT.S99577. PMC 4745952. PMID 26893564.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ Barnes TR, McPhillips MA (1995). "How to distinguish between the neuroleptic-induced deficit syndrome, depression and disease-related negative symptoms in schizophrenia". Int Clin Psychopharmacol. 10 Suppl 3: 115–121. doi:10.1097/00004850-199509000-00015. PMID 8866773.
- ^ a b c Machida N, Shiotsuka S, Semba J (2005). 強迫性障害と抗精神病薬による欠陥症候群(NIDS)の合併例に抗精神病薬中止とSSRIが奏効した一例 [Case of obsessive-compulsive disorder associated with neuroleptics-induced deficit syndrome (NIDS): successfully treated by discontinuation of neuroleptics followed by SSRI.]. 精神神経学雑誌 [Seishin Shinkeigaku Zasshi] (in Japanese). 107 (7): 667–673. PMID 16146185.