The iatrogenic nature of supersensitivity psychosis raises questions about the use of antipsychotic medications as they may ultimately cause adaptive changes in the brain that lead to treatment AR-A014418 supplier failure. Caution should be exercised before increasing doses in relapsing patients. It is suggested that further research into prescribing regimes is required, including alternative dosing strategies, switching Inhibitors,research,lifescience,medical to antipsychotics with a lower affinity for dopamine D2 receptors and augmentation with novel agents. As the main providers of community mental healthcare, CPNs occupy a key position in monitoring and supporting people with psychosis. An awareness that relapses can occur in medication-compliant

patients will inform assessments of mental health and avoid mistrust occurring in the nurse–patient relationship. Furthermore, as AIMs and life events may provoke a breakthrough of psychotic Inhibitors,research,lifescience,medical symptoms, mental health nurses need training

in recognizing side effects and how to assess for life events. Appendix 1 Supersensitivity psychosis checklist Supersensitivity psychosis syndrome recognition criteria Criterion Description A International Classification Inhibitors,research,lifescience,medical of Diseases (ICD-10) diagnosis of schizophrenia or schizoaffective psychosis. Treated > 1 year with antipsychotic medication (excludes clozapine and quetiapine). Compliant with antipsychotic medication. B Emergence or exacerbation of positive psychotic symptoms from the following list: hallucinations, including nonverbal

auditory, verbal Inhibitors,research,lifescience,medical auditory, functional hallucinations, visual hallucinations and olfactory hallucinations; delusions, including delusions of misinterpretation, misidentification, persecution, conspiracy, religious delusions and delusions of grandiose abilities; thought disorder, including thoughts being read, loud thoughts, thought echo, thought broadcast and thought insertion. C Abnormal Inhibitors,research,lifescience,medical involuntary movements, which may include movements of the tongue, face, jaw, lips and trunk, also purposeless jerky or writhing movements of limbs; excludes Parkinsonian tremor, rigidity and associated akathesia. D Life events are likely to be absent or of a minor degree of threat. E The symptoms of criteria B and C are clinically significant identified by the fact that they cause interference of social and/or occupational functioning. Sclareol F The symptoms are not due to any organic brain injury, alcohol consumption acceptable if within British Medical Association guidelines (alcohol guidelines for sensible drinking 1995, 14 units per week for women, 21 units per week for men); there should be no significant illicit drug misuse. Footnotes This work was supported by the Department of Health UK R&D Training Fellowship (grant number RDO/33/94) to Paul Fallon. The authors declare no conflicts of interest in preparing this article.