Fluvoxamine may prevent onset of psychosis: a case report of a patient at ultra-high risk of psychotic disorder |
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Authors: | Shigenori Tadokoro Nobuhisa Kanahara Shuichi Kikuchi Kenji Hashimoto Iyo Masaomi |
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Institution: | 1. Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan 2. Department of Psychiatry, Sodegaura Satsukidai Hospital, Chiba, Japan 3. Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
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Abstract: | Background There is emerging evidence that antidepressants may be effective in preventing patients with non-specific and psychotic-like prodromal symptoms, defined as patients at ultra-high risk (UHR) of psychotic disorder, from transitioning to psychosis. However, the mechanism of such an effect is still unknown. Methods We report the case of a 19-year-old Japanese man determined to be at UHR of psychotic disorder in whom fluvoxamine (one of the antidepressants with sigma-1 receptor agonism) showed preventive effects on psychotic-like prodromal symptoms. Results Our patient's depressive symptoms were reduced and maintained below remission as a result of treatment with 100 mg/day of fluvoxamine. In addition, it is likely that an additional dose of fluvoxamine (50 mg/day) improved his psychotic-like prodromal symptoms directly, independent of its antidepressive effects. Conclusion Fluvoxamine, a sigma-1 receptor agonist, may be effective in preventing patients at UHR of psychotic disorder from onset of psychosis via its neuroprotective/neurotropic actions, independent of its antidepressive effects. |
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