PMID- 17650054
OWN - NLM
STAT- MEDLINE
DCOM- 20070827
LR  - 20070725
IS  - 1555-2101 (Electronic)
IS  - 0160-6689 (Linking)
VI  - 68 Suppl 6
DP  - 2007
TI  - Switching antipsychotic therapy: what to expect and clinical strategies for 
      improving therapeutic outcomes.
PG  - 10-3
AB  - When a patient taking an antipsychotic is not experiencing symptomatic remission, 
      or is experiencing adverse effects (AEs) that are intolerable or damaging to his 
      or her physical health, a change in medication may be the best path to a good 
      outcome. However, many clinicians are reluctant to switch medications in all but 
      the clearest cases of failure. This reluctance is intensified by the occurrence 
      of AEs caused by transitioning patients too rapidly between agents with different 
      receptor-binding profiles. Emergent antipsychotic-switching syndromes include the 
      "withdrawal triad," comprised of cholinergic rebound, supersensitivity psychosis, 
      and emergent withdrawal dyskinesias (and other motor syndromes). More recently, 
      another element has been observed consistent with an activation syndrome. This 
      activation syndrome may occur as a consequence of switching from highly sedative 
      agents or as a consequence of initial prodopaminergic drive. All of these effects 
      can be minimized by careful planning of gradual switch procedures and judicious 
      use of adjunctive medications.
FAU - Lambert, Tim J
AU  - Lambert TJ
AD  - Department of Psychological Medicine, University of Sydney, Sydney, Australia. 
      tlambert@med.usyd.edu.au
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - J Clin Psychiatry
JT  - The Journal of clinical psychiatry
JID - 7801243
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Antipsychotic Agents/*administration & dosage/*adverse effects
MH  - Humans
MH  - Patient Care Planning
MH  - Psychotic Disorders/drug therapy/psychology
MH  - *Substance Withdrawal Syndrome
MH  - Treatment Failure
RF  - 16
EDAT- 2007/07/31 09:00
MHDA- 2007/08/28 09:00
CRDT- 2007/07/31 09:00
PHST- 2007/07/31 09:00 [pubmed]
PHST- 2007/08/28 09:00 [medline]
PHST- 2007/07/31 09:00 [entrez]
PST - ppublish
SO  - J Clin Psychiatry. 2007;68 Suppl 6:10-3.