Can psychosis result from anti-psychotic medication withdrawal for a non-psychotic patient? That is, a patient that takes anti-psychotic medication for off label reasons, such as treatment-resistant depression, or insomnia.

  • $\begingroup$ When you say non-psychotic do you mean not diagnosed with a psychotic disorder? With no psych issues, psychotic or otherwise ever? No schizotypal personality disorder? Nothing that suggests unmasking rather than creation... $\endgroup$ – mac389 Jun 25 '15 at 23:44
  • $\begingroup$ Correct, no psychotic symptoms ever. Also, the question is about dopamine antagonists. $\endgroup$ – jiniyt Jun 26 '15 at 7:55
  • $\begingroup$ Can you specify which class of DA antagonists? Or even a specific drug. Typical antipsychotics also bind to histamine and acetylcholine receptors. This binding influences perception. $\endgroup$ – mac389 Jun 26 '15 at 16:13
  • $\begingroup$ atypical antipsychotics such as paliperidone, qutiapine, clozapine, olanzapine, ziprasidone. $\endgroup$ – jiniyt Jun 27 '15 at 5:44

It depends on what you mean by psychosis.

Anti-psychotic medications effectively reduce the positive symptoms of schizophrenia (hallucinations, paranoia) at the expense of worsening the negative symptoms (rigidity, bradykinesia, cognitive slowing). Long-term use of antipsychotics, especially the older ones, can induce a Parkinson's-like syndrome.

These effects are not withdrawal so much as side effect of the medication.

Second generation antipsychotics are used as mood stabilizers in bipolar II and major depression. Post-marketing surveys of aripiperazole and the like have not bred rebound psychosis.

Use of dopamine agonists is associated with psychosis.

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  • $\begingroup$ Not to be chatty, but glad to see you are back around. :) $\endgroup$ – Chuck Sherrington Jun 25 '15 at 23:31
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    $\begingroup$ Thanks. Let's see if I can keep it up this time. Who would have thought a physician-scientist would be so busy? $\endgroup$ – mac389 Jun 25 '15 at 23:43

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