Treatment of generalized tardive dystonia with clozapine

Psychiatr Danub. 2008 Sep;20(3):329-31.

Abstract

Tardive dystonia is a syndrome of sustained muscle contractions, frequently causing twisting and repetitive movements or abnormal postures, associated with prolonged exposure to antipsychotics. We report a case of a 35-year-old patient with schizophrenia who developed a generalized form of tardive dystonia after switching of clozapine to risperidone treatment that persisted after switch to olanzapine and during the period while treatment with an antipsychotic was discontinued. It was successfully managed with reintroduction of clozapine. The case may represent the first report of generalized tardive dystonia while taking risperidone. The possible pathophysiological bases of the disorder are discussed. The goal of our report is to emphasize that an adequate trial of clozapine is a worthwhile option in the cases of tardive dystonia, even where discontinuation of antipsychotics was unsuccesful.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use*
  • Clozapine / therapeutic use*
  • Dyskinesia, Drug-Induced / drug therapy*
  • Dyskinesia, Drug-Induced / etiology
  • Dyskinesia, Drug-Induced / physiopathology
  • Dystonic Disorders / chemically induced*
  • Dystonic Disorders / drug therapy
  • Dystonic Disorders / physiopathology
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Male
  • Psychiatric Status Rating Scales
  • Receptors, GABA / physiology
  • Receptors, Muscarinic / physiology
  • Risperidone / adverse effects
  • Risperidone / therapeutic use

Substances

  • Antipsychotic Agents
  • Receptors, GABA
  • Receptors, Muscarinic
  • Clozapine
  • Risperidone