Dopamine Supersensitivity Psychosis: A Systematized Review of Clinical Evidence and Diagnostic Validity

Dopamine supersensitivity psychosis (DSP) is a proposed consequence of long-term dopamine D2 receptor antagonist treatment, characterized by psychotic relapse or symptom exacerbation following dose reduction, discontinuation, or switching, and often associated with tolerance to antipsychotic effects and tardive dyskinesia. Despite frequent citation of the concept in clinical psychiatry, the validity of DSP as a diagnostic entity, its clinical characteristics, and its relationship to treatment resistance remain unclear. This systematized review incorporates several systematic elements (structured search, predefined inclusion/exclusion criteria, duplicate screening, and formal risk-of-bias assessment) but does not fully meet all PRISMA criteria for a registered systematic review. The aim is to comprehensively collect and critically appraise clinical human data related to DSP, with particular attention to diagnostic validity based on validators adapted from Robins & Guze (clinical features, course, treatment response, biomarkers, and genetic susceptibility).