Neuroleptic-Induced Dopamine Supersensitivity Psychosis (DSP) was a concept first introduced by psychiatrist Guy Chouinard in 1980.[1]
Hypothesis
The hypothesis is that chronic antipsychotic use leads to the upregulation of dopamine (D2) receptors in the basal ganglia (and thus, tardive dyskinesia).
Further, is it also characterized by tolerance to increasing doses of antipsychotic.
Finally, most clinically relevant is the hypothesis that rebound psychosis could occur with a reduction or discontinuation of the antipsychotic (separate from the underlying disease course itself).
Controversy
The idea that neuroleptic-induced dopamine supersensitivity psychosis could be iatrogenic is re-emerging in the research literature. This is a controversial, but clinically relevant concept that requires ongoing research because the clinical impact could be significant.