Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Case report

Remission of irreversible aripiprazole-induced tardive dystonia with clozapine: a case report

Authors: Soohyun Joe, Jangho Park, Jongseok Lim, Choongman Park, Joonho Ahn

Published in: BMC Psychiatry | Issue 1/2015

Login to get access

Abstract

Background

Aripiprazole can cause irreversible tardive dystonia in some individuals, and additional intervention is sometimes needed. Here, we report the first case of aripiprazole-induced irreversible tardive dystonia in which complete recovery of motor function was achieved using the antipsychotic drug clozapine.

Case presentation

A 24-year-old man with bipolar disorder was treated with aripiprazole and gradually developed tardive dystonia. Thorough medical and neurological examinations were performed to rule out other possible causes of tardive dystonia. Clozapine was administered when the patient did not improve following long-term withdrawal of aripiprazole or adjuvant medications. Before administration of clozapine, the patient was experiencing severe dystonia as assessed by the Extrapyramidal Symptom Rating Scale. Dystonic symptoms began to improve about 1 month after starting administration of clozapine and were completely resolved 3 months after clozapine administration.

Conclusions

Clinicians should note the risk of aripiprazole-induced tardive dystonia and consider clozapine as an alternative and effective treatment modality in cases of irreversible tardive dystonia, particularly when concomitant treatment of psychotic symptoms is required.
Literature
1.
Marsalek M. Tardive drug-induced extrapyramidal syndromes. Pharmacopsychiatry. 2000;33 Suppl 1:14–33.CrossRefPubMed
2.
3.
Louza MR, Bassitt DP. Maintenance treatment of severe tardive dyskinesia with clozapine: 5 years’ follow-up. J Clin Psychopharmacol. 2005;25(2):180–2.CrossRefPubMed
4.
5.
Klawans Jr HL, Rubovits R. An experimental model of tardive dyskinesia. J Neural Transm. 1972;33(3):235–46.CrossRefPubMed
6.
Jeste DV. Tardive dyskinesia rates with atypical antipsychotics in older adults. J Clin Psychiatry. 2004;65 Suppl 9:21–4.PubMed
7.
Kane JM. Tardive dyskinesia rates with atypical antipsychotics in adults: prevalence and incidence. J Clin Psychiatry. 2004;65 Suppl 9:16–20.PubMed
8.
Grunder G, Carlsson A, Wong DF. Mechanism of new antipsychotic medications: occupancy is not just antagonism. Arch Gen Psychiatry. 2003;60(10):974–7.CrossRefPubMed
9.
Kantrowitz JT, Srihari VH, Tek C. Resolution of tardive dyskinesia after addition of aripiprazole to haloperidol depot. J Clin Psychopharmacol. 2007;27(5):525–6.CrossRefPubMed
10.
Lungu C, Aia PG, Shih LC, Esper CD, Factor SA, Tarsy D. Tardive dyskinesia due to aripiprazole: report of 2 cases. J Clin Psychopharmacol. 2009;29(2):185–6.CrossRefPubMed
11.
Matsuda N, Hashimoto N, Kusumi I, Ito K, Koyama T. Tardive laryngeal dystonia associated with aripiprazole monotherapy. J Clin Psychopharmacol. 2012;32(2):297–8.CrossRefPubMed
12.
13.
Pinninti NR, Mago R, Adityanjee. Tardive dystonia-associated prescription of aripiprazole. J Neuropsychiatry Clin Neurosci. 2006;18(3):426–7.CrossRefPubMed
14.
Friedman JH. Tardive dystonia due to aripiprazole use in a neuroleptic-naive patient. J Clin Psychiatry. 2010;71(5):652–3.CrossRefPubMed
15.
Sato K, Yoshida K, Higuchi H. Probable aripiprazole-induced tardive writer’s cramp. J Neuropsychiatry Clin Neurosci. 2012;24(3):e44.CrossRefPubMed
16.
Bhidayasiri R, Fahn S, Weiner WJ, Gronseth GS, Sullivan KL, Zesiewicz TA, et al. Evidence-based guideline: treatment of tardive syndromes: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013;81(5):463–9.CrossRefPubMed
17.
Larach VW, Zamboni RT, Mancini HR, Mancini RR, Gallardo RT. New strategies for old problems: tardive dyskinesia (TD). Review and report on severe TD cases treated with clozapine, with 12, 8 and 5 years of video follow-up. Schizophr Res. 1997;28(2–3):231–46.PubMed
18.
Margolese HC, Chouinard G, Kolivakis TT, Beauclair L, Miller R, Annable L. Tardive dyskinesia in the era of typical and atypical antipsychotics. Part 2: Incidence and management strategies in patients with schizophrenia. Can J Psychiatr Rev Can Psychiatr. 2005;50(11):703–14.
19.
Burke RE, Fahn S, Jankovic J, Marsden CD, Lang AE, Gollomp S, et al. Tardive dystonia: late-onset and persistent dystonia caused by antipsychotic drugs. Neurology. 1982;32(12):1335–46.CrossRefPubMed
20.
21.
Casey DE. Affective disorders and tardive dyskinesia. L’Encéphale. 1988;14:221–6.PubMed
22.
Hazari N, Kate N, Grover S. Clozapine and tardive movement disorders: a review. Asian J Psychiatry. 2013;6(6):439–51.CrossRef
23.
Aquino CC, Lang AE. Tardive dyskinesia syndromes: current concepts. Parkinsonism Relat Disord. 2014;20 Suppl 1:S113–7.CrossRefPubMed
24.
Cho CH, Lee HJ. Oxidative stress and tardive dyskinesia: pharmacogenetic evidence. Prog Neuro-Psychopharmacol Biol Psychiatry. 2013;46:207–13.CrossRef
25.
Teo JT, Edwards MJ, Bhatia K. Tardive dyskinesia is caused by maladaptive synaptic plasticity: a hypothesis. Mov Disord: Off J Movement Disord Soc. 2012;27(10):1205–15.CrossRef
26.
27.
Trugman JM, Leadbetter R, Zalis ME, Burgdorf RO, Wooten GF. Treatment of severe axial tardive dystonia with clozapine: case report and hypothesis. Mov Disord: Off J Movement Disord Soc. 1994;9(4):441–6.CrossRef
28.
Nordström AL, Farde L, Nyberg S, Karlsson P, Halldin C, Sedvall G. D1, D2, and 5-HT2 receptor occupancy in relation to clozapine serum concentration: a PET study of schizophrenic patients. Am J Psychiatry. 1995;152(10):1444–9.CrossRefPubMed
29.
Bolden C, Cusack B, Richelson E. Clozapine is a potent and selective muscarinic antagonist at the five cloned human muscarinic acetylcholine receptors expressed in CHO-K1 cells. Eur J Pharmacol. 1991;192(1):205–6.CrossRefPubMed
Metadata
Title
Remission of irreversible aripiprazole-induced tardive dystonia with clozapine: a case report
Authors
Soohyun Joe
Jangho Park
Jongseok Lim
Choongman Park
Joonho Ahn
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0644-1

Other articles of this Issue 1/2015

BMC Psychiatry 1/2015 Go to the issue

Erratum

Erratum: Neurobehavioral consequences of chronic intrauterine opioid exposure in infants and preschool children: a systematic review and meta-analysis

Research article

Obsessive-compulsive disorder is a heterogeneous disorder: evidence from diffusion tensor imaging and magnetization transfer imaging

Research article

Assessing health status in informal schizophrenia caregivers compared with health status in non-caregivers and caregivers of other conditions

Research article

Changes in mental disorder prevalence among conflict-affected populations: a prospective study in Sri Lanka (COMRAID-R)

Research article

Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record

Case report

Lithium as a rescue therapy for regression and catatonia features in two SHANK3 patients with autism spectrum disorder: case reports