Journal article
Psychosis After Switch in Opioid Maintenance Agonist and Risperidone-Induced Pisa Syndrome: Two Critical Incidents in Dual Diagnosis Treatment.
- Sutter M a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland.
- Walter M a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland.
- Dürsteler KM a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland.
- Strasser J a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland.
- Vogel M a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland.
- 2016-12-10
Published in:
- Journal of dual diagnosis. - 2017
Pisa syndrome
QT prolongation
Schizophrenia
comorbidity
methadone
opioid maintenance treatment
opioid use disorder
risperidone
slow release morphine
substance use disorder
Administration, Oral
Analgesics, Opioid
Antipsychotic Agents
Delayed-Action Preparations
Diagnosis, Dual (Psychiatry)
Drug Substitution
Dystonia
Female
Humans
Long QT Syndrome
Methadone
Middle Aged
Morphine
Opiate Substitution Treatment
Opioid-Related Disorders
Psychoses, Substance-Induced
Risperidone
Schizophrenia
Syndrome
English
BACKGROUND AND AIMS
Dual diagnosis commonly occurs among patients with an opioid use disorder. Treatment is ideally performed in an integrated fashion. We present a case that illustrates the complex and challenging psychiatric and medical therapy of such patients in the light of the literature.
CASE DESCRIPTION
We report on a 56-year-old patient with schizophrenia and opioid dependence who experienced both risperidone-induced Pisa syndrome and, 3 years later, acute psychosis after switching the opioid substitution medication from methadone to slow-release oral morphine due to QT prolongation.
CONCLUSIONS
With the current availability of a diversity of substitution opioids in Switzerland (methadone, buprenorphine, diacetylmorphine, sustained-release oral morphine), studies on differential effectiveness of these agents in opioid-dependent subpopulations with selective comorbidity profiles are desirable. The same is true for further investigation of the involvement of the opioid receptor system in schizophrenia. In clinical practice, any alteration of opioid medication in patients with dual diagnosis and a history of schizophrenia should be accompanied by close observation for psychotic symptoms.
Dual diagnosis commonly occurs among patients with an opioid use disorder. Treatment is ideally performed in an integrated fashion. We present a case that illustrates the complex and challenging psychiatric and medical therapy of such patients in the light of the literature.
CASE DESCRIPTION
We report on a 56-year-old patient with schizophrenia and opioid dependence who experienced both risperidone-induced Pisa syndrome and, 3 years later, acute psychosis after switching the opioid substitution medication from methadone to slow-release oral morphine due to QT prolongation.
CONCLUSIONS
With the current availability of a diversity of substitution opioids in Switzerland (methadone, buprenorphine, diacetylmorphine, sustained-release oral morphine), studies on differential effectiveness of these agents in opioid-dependent subpopulations with selective comorbidity profiles are desirable. The same is true for further investigation of the involvement of the opioid receptor system in schizophrenia. In clinical practice, any alteration of opioid medication in patients with dual diagnosis and a history of schizophrenia should be accompanied by close observation for psychotic symptoms.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1080/15504263.2016.1269224
- PMID 27935442
- Persistent URL
- https://sonar.rero.ch/global/documents/182329
Statistics
Document views: 22
File downloads: