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Pharmacopsychiatry 2015; 48(03): 104-110
DOI: 10.1055/s-0034-1398612
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Atypical Antipsychotics and Relapsing Psychoses in 22q11.2 Deletion Syndrome: A Long-term Evaluation of 28 Patients

W. M. A. Verhoeven
1   Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Neuropsychiatry, Venray, The Netherlands
2   Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, The Netherlands
,
J. I. M. Egger
1   Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Neuropsychiatry, Venray, The Netherlands
3   Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
4   Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
› Author Affiliations
Further Information

Publication History

received 07 July 2014
revised 15 November 2014

accepted 07 January 2015

Publication Date:
05 February 2015 (online)

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Abstract

Introduction: This study includes 28 patients with genetically proven 22q11.2 deletion syndrome referred for treatment-resistant psychoses and aims at the identification of a suitable pharmacological treatment strategy.

Methods: Based on standardized diagnostic procedures, key psychiatric symptoms and cognitive status were assessed. Also, data about previous diagnostic vignettes as well as the history of psychotropic medication and medical conditions were collected. Finally, the effect of the subsequent treatment regimen was periodically re-assessed.

Results: Since psychotic symptoms had been shown to be non-responsive to conventional antipsychotics including risperidone, treatment with either clozapine or quetiapine was started. In 21 patients, a substantial reduction of psychotic symptoms was achieved with either one, and in 3-quarters of this group remission was attained over a longer follow-up period. In a significant number of patients, valproic acid was added either for mood stabilizing purposes or to avoid epileptic side effects of clozapine.

Discussion: Treatment of psychotic symptoms in patients with 22q11DS with the atypical antipsychotic quetiapine or clozapine in combination with the mood-stabilizing anticonvulsant valproic acid, appears likely to be more effective than with other psychotropic compounds.

Key words

22q11.2 deletion syndrome - schizophrenia-like psychosis - atypical antipsychotic - social cognition
 

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