Improvement of tardive dyskinesia and dystonia associated with aripiprazole following a switch to quetiapine: case report and review of the literature

• Published in: Journal of clinical pharmacy and therapeutics Vol. 37; no. 3; pp. 370 - 372
• Main Authors: Ono, S., Suzuki, Y., Shindo, M., Endo, T., Fukui, N., Sugai, T., Someya, T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2012; Blackwell; Hindawi Limited
• Subjects: Adult; Adult and adolescent clinical studies; Age Factors; Akathisia, Drug-Induced - prevention & control; Antipsychotic Agents - administration & dosage; Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Aripiprazole; Biological and medical sciences; Dibenzothiazepines - administration & dosage; Dibenzothiazepines - therapeutic use; Dopamine D2 Receptor Antagonists; Dose-Response Relationship, Drug; Drug Monitoring; Female; Humans; Male; Medical sciences; movement disorders; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Pharmacology. Drug treatments; Piperazines - administration & dosage; Piperazines - adverse effects; Piperazines - therapeutic use; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Quetiapine Fumarate; Quinolones - administration & dosage; Quinolones - adverse effects; Quinolones - therapeutic use; Risk Factors; Schizophrenia; Schizophrenia - drug therapy; second‐generation antipsychotics; Sex Characteristics; side effect; Treatment Outcome; Young Adult; Partial agonist; Atypical antipsychotic; Neuroleptic; Psychotropic; Toxicity; Quinolinone derivatives; Schizophrenia; Aripiprazole; Involuntary movement; Psychosis; 5-HT1A Serotonine receptor; Secondary effect; Antagonist; Dibenzothiazepine derivatives; Neurological disorder; Quetiapine; Dyskinesia; 5-HT2A serotonin receptor; Human; side effect; Nervous system diseases; Late; Hypnotic; Motor control; Cerebral disorder; Case study; second-generation antipsychotics; Striated muscle disease; D2 Dopamine receptor; Tranquillizer; Central nervous system disease; Dystonia; movement disorders; Bibliographic review; Extrapyramidal syndrome
• ISSN: 0269-4727; 1365-2710
• DOI: 10.1111/j.1365-2710.2011.01290.x

Summary What is known and Objective:  Aripiprazole has a low risk of extrapyramidal symptoms. Switching to aripiprazole has been reported to improve tardive dyskinesia caused by other medications. The authors report a case and review previous reports of dystonia and dyskinesia associated with aripiprazole. Case summary:  We present a case of a 22‐year‐old man with schizophrenia who experienced dyskinesia and dystonia associated with aripiprazole. Switching from olanzapine to aripiprazole resulted in worsening dyskinesia and new onset of dystonia. The patient’s dyskinesia and dystonia improved after switching from aripiprazole to quetiapine therapy. What is new and Conclusion:  There were several previous case reports on dyskinesia and dystonia associated with aripiprazole medication. The risk factors for tardive dyskinesia include older age and female sex. However, our case was a male patient who was younger compared with the previous cases and so should have been less at risk for dyskinesia in comparison with the previous cases. The effects of aripiprazole can include tardive movement disorders. Dyskinesia, dystonia and psychotic symptoms were improved with relatively small dose of quetiapine in this case. Whether some second‐generation antipsychotics are more effective than others in the treatment of tardive dyskinesia remains unclear.