Understanding the "Ups and Down of Dopamine" to prevent risk and inform treatment of psychotic disorders

Date: Wednesday 16 June
Time: 4.10pm - 5.25pm

Overview

This symposium proposes to explore the central role that the dopamine system maintains in the aetiology and treatment of psychotic disorders.

Dr Corbeil, winner of the Rober Kervin Prize, will present data responding the wide concern about an increased risk of psychotic events following the treatment with either psychostimulants or atomoxetine in adults with an ADHD diagnosis and co-morbid schizophrenia spectrum and other psychotic disorders (SZSPD). Dr Corbeil shows that the risk of hospital admission for psychosis decreases following the introduction of methylphenidate, amphetamines and atomoxetine when used in combination with antipsychotics. 

Therefore, it is important to distinguish the effects of prescribed stimulants aimed to treat a specific dopamine deficit from their recreational use.

Professor Martinotti, will report on the association between psychostimulants and transient or persistent psychotic syndromes through dopaminergic hyperactivity. Data from his group show that these stimulant-induced psychoses share several neurobiological features with schizophrenia, including sensitisation phenomena, D2 receptor upregulation, and dysregulation of the cortico-striatal-thalamic loop. Moreover, while most cases remit with abstinence, a significant proportion progress to chronic psychosis. Therefore, early identification, combined pharmacological management and sustained follow-up are crucial to prevent in this group, chronicity and relapse.

Finally, Professor Di Forti, will report on the data about patients with psychosis who use cannabis heavily who show a reduction in striatal dopamine compared to patients with psychosis without cannabis use. Data which question the use of full dopamine antagonist in this clinical population. Indeed, recent and consistent evidence show that alongside Clozapine, partial dopamine agonists are the most effective and tolerated antipsychotics in patients with a psychotic disorder and co-morbid cannabis use.

In conclusion, a better understanding of the “Up and Downs” of the dopamine system can lead to better prevention and more tailored treatment in Clinical Psychosis.

This session aims to:

  • Improve treatment of patients with psychosis and ADHD
  • Use existing data on the dopamine system to guide more tailored prescription of antipsychotics
  • Separate the risks associated with prescribed stimulants and their recreational use
  • Improve the pharmacological treatment of patients with psychotic disorders and co-morbid cannabis dependence

Speakers

  • Chair: Professor Marta Di Forti, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London
  • Treatment with psychostimulants and atomoxetine in people with psychotic disorders: reassessing the risk of clinical deterioration in a real-world setting
    • Dr Olivier Corbeil, Laval University, Quebec, Canada
  • Riding the dopamine high: psychosis from stimulant and party drugs use
    • Professor Giovanni Martinotti, Department of Neuroscience, University G.d’Annunzio of Chieti-Pescara, Pescara, Italy
  • How to guide pharmacological treatment of cannabis associated psychosis following the dopamine lead
    • Professor Marta Di Forti, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London
Register for Congress 2026

Please email congress@rcpsych.ac.uk or call 020 8618 4120 with any enquiries.