“Treatment Resistant” Schizophrenia Strongly Linked to Dopamine Supersensitivity

Rob Wipond
25
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Over 70% of schizophrenia patients who are “treatment resistant” have apparently developed dopamine supersensitivity psychosis from long-term use of antipsychotic medications, according to a study in Psychiatry Research.

Researchers from Chiba University in Japan examined 611 patients from three hospitals, and identified 147 patients who met the criteria for “treatment-resistant schizophrenia” (TRS). Of these, they found that 106 (72.1%) seemed to have dopamine supersensitivity psychosis (DSP).

The researchers defined DSP in this way: “Briefly, the criteria focus on three factors as follows; (1) rebound psychosis, (2) developed tolerance to antipsychotic effect, (3) presence of TD [tardive dyskinesia]. If the patient experienced at least one of these three criteria at any time during the treatment, the patient was judged as the presence [sic] of DSP episode.”

“Of the DSP patients, 42% and 56% experienced rebound psychosis and tolerance to antipsychotic effects, respectively,” wrote the researchers. “The present study revealed that approximately 70% of TRS patients experienced one or more DSP episodes, which may have a strong impact on the long-term prognosis of patients with schizophrenia.”

Suzuki, Tomotaka, Nobuhisa Kanahara, Hiroshi Yamanaka, Masayuki Takase, Hiroshi Kimura, Hiroyuki Watanabe, and Masaomi Iyo. “Dopamine Supersensitivity Psychosis as a Pivotal Factor in Treatment-Resistant Schizophrenia.” Psychiatry Research 0, no. 0. Accessed April 10, 2015. doi:10.1016/j.psychres.2015.02.021. (Abstract)

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Rob Wipond
Rob Wipond is a Victoria, British Columbia-based freelance journalist who has been writing on mental health issues for fifteen years. His research has particularly focused on the interfaces between psychiatry, the justice system, and civil rights. His articles have been nominated for three Canadian National Magazine Awards, six Western Magazine Awards, and four Jack Webster Awards for journalism. He can be contacted through his website.

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25 COMMENTS

  1. bout time this came out. I saw a schizophrenic go from fully functional, not having many of the symptoms he had just 7 years later. He had progressed to fully treatment resistive state, the damage like done by the drugs to the point they didn’t have any effect any longer. He started off on Haldol, and went to Clozaril in that time. His new symptoms included uncontrollable yelling and fits of rage that would occur like a tick, a dystonic “Tourette’s” tick they created inside him. He could not help but yell out to his voices. He would be able to control himself only temporarily. He used to be quiet and sedated by the drugs, no longer tho..

    His new diagnosis is likely, “chronic traumatic encephalopathy” from long-term neuroleptic use.

    It’s possible the government started using electronic warfare on him, because it’s impossible to tell who they’re using their weapons on anymore and they seek out new hosts. The weapon is not stoppable with drugs. http://www.drrobertduncan.com

    • Hi Todd
      Probably everyone taking these drugs will eventually end up psychiatric. I’ve experienced long term drug withdrawal syndrome and its possible to adapt with decent help. The main problem I think, is the medical denial and misdiagnosis.

  2. Todd: This is very tragic. But as long as there is life, there is hope. There may be new developments in nutrition and other therapies that ‘first do no harm’ that could help your friend heal from the dopamine supersensitivity he is experiencing. I totally understand the Tourette’s like ‘tics’ that present as unpredictable rage and anger. My daughter on neuroleptics experiences frequent small explosions then goes back to being calm. She experiences them particularly when her dosage is decreased too rapidly. Naturally, we are very keen to reduce her medications to the greatest extent possible, even eliminate them all together when and if that can be safely done, but withdrawal is fraught with risk of a loved one experiencing a withdrawal crisis that is misinterpreted leading to hospitalization and even higher medication. Treatment providers, unconsciously hostile to consumers and loved ones seeking alternatives to meds, often taper people too quickly, a set up for failure and an almost sure pathway to getting on even higher doses and polypharmacy. It is really important to work with a supportive and compassionate prescriber during the withdrawal/reduction phase but in our experience, such providers are few and far between. But as long as there is life, there is hope. Never, ever write anyone off! Your friend is lucky to have you in his court. I hope you correspond with him regularly and let him know that he is not forgotten!

  3. Never mind “schizophrenia” for a moment. Think of all the children who are forced to take these drugs for behavioral purposes, or to treat the side effects of other psych drugs. Proof that they’re not normalizing brain/neurotransmitter function, but rather perturbing it and at least to some degree permanently so. Where’s the outrage? Where’s the ban? What about all the children who’ll spend their lives with dysfunctional dopaminergicc systems? And all because of drugs that were never even supposed to be used in children in the first place. What was, and still is, totally an experiment… that is continuing to be allowed despite what science now knows for sure about these drugs… it’s an atrocity.

    • I agree, JeffreyC, drugging children with the neuroleptics is an atrocity. And some people are “treatment resistant” because the antipsychotics can do the opposite of what they are supposed to do. The neuroleptics / antipsychotics can make a non-psychotic person psychotic. Proof from drugs.com:

      “neuroleptics … may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

      As a previously healthy adult, given a child’s dose of Risperdal, due to a misdiagnosis (according to the DSM-IV-TR) of antidepressant withdrawal syndrome as “bipolar. I was made psychotic within two weeks of being put on an antipsychotic. This means .5mg of Risperdal is not a safe dose of Risperdal for any child, either.

      I would imagine there is a huge problem of doctors, other than just mine, misdiagnosing the central symptoms of neuroleptic induced anticholinergic intoxication syndrome as either bipolar or schizophrenia.

      And, absolutely, there is a huge problem with doctors misdiagnosing drug withdrawal induced super sensitivity manic psychosis as a return of the either bipolar or schizophrenia also.

      Wake up and learn about the actual effects of your drugs, doctors. There’s way too much catch 22ing innocent healthy people, and putting them into insane double bind situations, and creating “mental illnesses” for profit going on in our society.

      The UN says, “forced psychiatric treatment is torture,” and it should not be legal.

    • Does anyone else here recognize rebound effects by their vengeful feeling? They’re mean.

      I need to get liquid amitriptyline and am now doing research to see where I can get it. Not Rite Aid. I’ve cut down from 150 mg to 45 mg and find myself up against electrical zaps, deep waves of pain, nausea, vertigo, and a feeling of mild existential dread that I’ve had with an allergic reaction to nortriptyline and with hyperthermia. I don’t know what to call that. If I didn’t know where it was coming from it would frighten me into going to an emergency room. Meanwhile, I’m holding at 45 mg, but still have to take an additional 10 to 20 mg during the day sometimes to stop the uproar in my body.

      It bites. Especially when the pills make ya’ psychotic or something near it. I cannot not thank psychiatry enough for desipramine and the bipolar II disorder that lead to a decade of useless drug cocktails. Now I’m working my way off the prescribing cascade that came with MS, which includes two antidepressants prescribed for nerve pain and sleep.

      The doses of psychoactive drugs available are not small enough, and that’s a problem with neuroleptics and benzos as well. It’s past time for pharmaceutical companies and doctors to make discontinuation less disturbing and symptomatic and to take the symptoms and conditions caused by these drugs seriously.

      The validation, vindication, information, and support I’ve gained through peer support and critical MDs and psychologists who know these experiences is priceless, and thus far is the most valuable resource for getting off useless and harmful psychoactive drugs and figuring out how to do so with the least punishment.

      Keeping people from getting on them in the first place, when they are of no benefit, is a much harder task. Why should we have to learn the hard way?

  4. How can anyone really tell what damage the drugs did ?

    I know about rebound psychosis from my experience with the hell from the center of hell psychosis from Zyprexa withdrawal. A psychosis I never had BEFORE ingesting that horrible stuff ?

    Was that Dopamine Super-sensitivity ?

    If it was dopamine super-sensitivity then why did I have that anhedonia that persisted long after I stopped taking it ? And why was it that Adderal relieved this lingering and horrible anhedonia ? And made me feel ‘normal’ again .

    I have read many posts in forums about the lingering anhedonia after exposure to neuroleptics Zyprexa and Invega especially . Anhedonia would suggest according to the dopamine theory a condition of low dopamine or low dopamine sensitivity.

    My experience did not include a diagnosis of schizophrenia or presence of TD [tardive dyskinesia].

    Bottom line these drugs absolutely do damage and no one knows the mechanisms of it. And if I listened to them and was compliant I would still be effed up on them or dead.

    Zyprexa, WTF was I thinking swallowing that and thinking nothing bad was going to happen ?

    It helps with anxiety and insomnia and “don’t worry it’s safe” .

    “Don’t worry it’s safe” . That doctor should loose his license and be sent to prison for telling me that.

    • Copy cat, I am interested in what you say about Adderall. I was just wondering today whether Dexedrine might help people with antidepressant-discontinuation-induced anhedonia and/or akathisia, though that does sound far-fetched, especially for akathisia.

      I am very glad to hear that it helped, and wonder if you could say a bit more about it, along the lines of…

      Did you have problems in addition to psychosis and anhedonia after the Zyprexa-withdrawal-induced hedonia?

      Who came up with the Adderall idea? Why did he or she propose it?

      As for doctors losing their licenses…seems very hard to do, and it is devastating to the patient-victims.

      I know of a psychiatrist in California who drugged and raped a woman he met in a bar, using pharma drugs. The CA medical board was informed, and the case is documented on their web site, but the board did not revoke his licence.

      I know of another psychiatrist who was banned from practice in NY, then warned by CA’s board, not long after relocating there–both times for over-prescribing Ritalin. A second warning was issued a few years later, but he is still practicing, too.

      In at least one case, when Ritalin made a patient anxious to the point of disability, the former NY doc added Adderall, which did not help, so naturally he added Prozac and Ativan. (Why he didn’t then advise snorting meth is an open question.) That patient entered a ruinous period of psychosis and developed symptoms that were diagnosed as intractable epilepsy. Recovery from psychosis and seizures occurred slowly, with no further drugs or doctors.

      • Having taken Dexadrine and Adderal before I just knew it would combat the anhedonia caused by the Zyprexa even if it was just replacing it with its own effect.

        Anhedonia is no joke, I could remember what it was like to be motivated and to want but I couldn’t feel it.

        I remember going to the natural history museum on that wicked Zyprexa being totally unable to feel that sense of wonder like I felt years before looking at the display of the meteorite.

        That stuff was just an insidious robbery of everything that makes life life.

        I am just lucky I survived and recovered from psychiatry’s chemicals as well as I did.

  5. I keep hoping against hope that the duplicity and intellectual dishonesty that seems to abound in mainstream biopsychiatry, much to the detriment of those caught in it’s pernicious web, will be exposed and corrected. There is a proverb that says “Hope deferred makes the heart sick.” I’ve been alternately hopeful and heartsick in recent years.

    This article strikes me as more than a ray of hope. In “Anatomy of an Epidemic” Robert Whitaker related how the concept of dopamine supersensitivity was first raised by physicians Guy Chouinard and Barry Jones back in the late 1970’s, but quickly dismissed by some of the key opinion leaders in psychiatry. As Whitaker said, “Psychiatry desperately needed this discussion to go away.” And it did, mostly, for over thirty years.

    However, it seems to be making it’s way back into professional dialogue other that just among the “choir” (like here in MIA). This study, I believe, bears out the old addage that “You can fool some of the people some of the the time….etc.” Kudos to those who refuse to yield to the pressure of the power brokers who will defend the status quo at any cost. Eventually, the truth prevails.

    • “Robert Whitaker related how the concept of dopamine supersensitivity was first raised by physicians Guy Chouinard and Barry Jones back in the late 1970’s, but quickly dismissed by some of the key opinion leaders in psychiatry. As Whitaker said, “Psychiatry desperately needed this discussion to go away.” And it did, mostly, for over thirty years.

      However, it seems to be making it’s way back into professional dialogue other that just among the “choir” (like here in MIA). This study, I believe, bears out the old addage that “You can fool some of the people some of the the time….etc.” ”

      But one way or another, psychiatry got away with 30 more years of needless brain damaging drugging, a time that ushered in their most prosperous era ever, saw them achieve the most legal and political power ever, and expand their drugging to millions of children. The fact that dopamine supersensitivity is making a comeback, along with Whitaker’s historical documentation of how psychiatry swept it under the rug, is proof enough that psychiatry is culpable of crimes against humanity. That the theory was valid all along and their actions in suppressing it were dishonest and selfish, and lead to catastrophe amounts of harm, permanent damage and even death… even the death of children: http://www.ahrp.org/cms/content/view/158/52/

      When it comes to brain damage and psychiatric drugs, the quote by Phillip Dick says it at: ‘Reality is that which, when you stop believing in it, doesn’t go away.”

      Psychiatry has been, knowingly and willingly, trying to buy as much time as it can. I keep waiting for some sort of legal power to catch on to this and bring them the Nuremberg-esque trials that they deserve. They deserve nothing less.

      This is no time to be hopeful anymore than the day the Allies carpet bombed Germany was a day to be hopeful. The damage is already done. Plain and simple. It’s time for justice.

      • I appreciate your remarks, Jeffrey. While this article still leaves me feeling more hopeful, I don’t disagree about the need for justice. In fact, I’m working for it in some small local, “person-by-person” ways…and I’ve recently become part of something that will hopefully give me the opportunity to have a much broader impact. I really do wrestle with this issue–that is, how much to expend my efforts toward “re-education and reform” and how much toward bringing to justice those who seem impervious to change and blithely unconcerned about the damage they’re doing.