Adults with 22q11.2 deletion syndrome face a markedly elevated risk of schizophrenia or other psychotic disorders. When psychosis develops in this population, clinical management requires specific considerations that go beyond standard psychiatric practice.
Psychotic disorders such as schizophrenia occur at a 20-fold increased risk over general population expectations among individuals with 22q11.2 deletion syndrome — approximately 1 in 4 to 5 adults with the condition will develop schizophrenia. This protocol addresses pharmacologic management in this specific adult sub-population.
Management centers on standard pharmacologic treatment with antipsychotic medication. A particular dosing strategy is central to this approach in the context of 22q11.2 deletion syndrome, and specific co-medication considerations apply depending on which antipsychotic agent is selected.
Full regimen, agent selection guidance, and co-medication details are available in the complete protocol below.Also important are psychotic disorders such as schizophrenia given the 20-fold increased risk over general population expectations; about 1 in every 4 to 5 adults with 22q11.2DS will develop schizophrenia.
This includes pharmacologic treatments, eg, antipsychotic and antianxiety/antidepressant medications, with proven efficacy.
Patients may benefit from a “start low, go slow” approach to medication dosing.
One example is the effective treatment with clozapine for schizophrenia, in which the lowered seizure threshold of 22q11.2DS may be managed by this strategy and consideration of prophylactic use of anticonvulsant medication.
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