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Suppression of antipsychotic-induced tardive dyskinesia with aripiprazole in an elderly patient with bipolar I disorder

Published online by Cambridge University Press:  23 September 2013

Wei-Yi Wu ,
Hung-Yu Chan  and
Happy Kuy-Lok Tan
Wei-Yi Wu
Affiliation:
Department of Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan
Hung-Yu Chan*
Affiliation:
Department of Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan Department of Psychology, Chung Yuan Christian University, Chung-Li, Taiwan
Happy Kuy-Lok Tan
Affiliation:
Department of Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan
*
Hung-Yu Chan, Department of Psychiatry, Taoyuan Mental Hospital, 71, Long-show Street, 33058 Taoyuan city, Taiwan. Tel: +886 3 3698553; Fax: +886 3 3699498; E-mail: jan30@seed.net.tw
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Abstract

Introduction

Aripiprazole has a low risk for causing extrapyramidal syndrome and can remit neuroleptic-induced tardive dyskinesia (TD). Here, we presented a case in which TD was suppressed, but not cured, by long-term aripiprazole treatment.

Case

This 74-year-old male patient had bipolar I disorder and had developed TD many times after several antipsychotic treatments. The lowest chlorpromazine dose equivalent among the previous antipsychotic treatments was 25 mg/day of quetiapine. His TD always improved immediately after the dosage was shifted to aripiprazole. However, his insomnia or other psychiatric symptoms worsened the first three times when the treatment was shifted to aripiprazole, making the transition a failure. Before the fourth attempt of aripiprazole transition, the patient was in a euthymic state but again developed TD under olanzapine 10 mg/day treatment. During the fourth attempt of aripiprazole transition, his TD had remained in complete remission for more than 1 year after the dosage shifted to 10 mg/day of aripiprazole. He developed TD again when we tapered the aripiprazole dose to 5 mg/day, but his TD remitted when we restored his aripiprazole dose to 10 mg/day.

Conclusion

Aripiprazole could be an effective drug in elderly bipolar patients with antipsychotic-induced TD while the patients are in a euthymic state. However, aripiprazole may only suppress TD rather than cure it.

Keywords

antipsychoticaripiprazolebipolar disordertardive dyskinesia
Type
Case Report
Information
Acta Neuropsychiatrica , Volume 26 , Issue 1 , February 2014 , pp. 61 - 64
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2013 

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References

1.Yetimalar, Y, Secil, Y, Eren, S, Basoglu, M. A 6-month longitudinal study of early-onset tardive dyskinesia: association with olanzapine treatment and mild cognitive impairment in an elderly woman. J Clin Psychopharmacol 2007;27:210–212.Google Scholar
2.Chan, HY, Chiang, SC, Chang, CJet al. A randomized controlled trial of risperidone and olanzapine for schizophrenic patients with neuroleptic-induced tardive dyskinesia. J Clin Psychiatry 2010;71:1226–1233.CrossRefGoogle ScholarPubMed
3.Duggal, HS, Mendhekar, DN. Atypical antipsychotics, tardive dyskinesia, and D(2) receptors. Am J Psychiatry 2006;163:1449–1450.Google Scholar
4.Lykouras, L, Rizos, E, Gournellis, R. Aripiprazole in the treatment of tardive dyskinesia induced by other atypical antipsychotics. Prog Neuropsychopharmacol Biol Psychiatry 2007;31:1535–1536.Google Scholar
5.Shan, JC, Tseng, MC. Improvement in Pisa syndrome and tardive dyskinesia following aripiprazole treatment. J Neuropsychiatry Clin Neurosci 2009;21:350–351.CrossRefGoogle ScholarPubMed
6.Wang, LJ, Ree, SC, Chen, CK. Courses of aripiprazole-associated tardive dyskinesia: report of two cases. Prog Neuropsychopharmacol Biol Psychiatry 2009;33:743–744.Google Scholar
7.Hall, DA, Agarwal, P, Griffith, A, Segro, V, Seeberger, LC. Movement disorders associated with aripiprazole use: a case series. Int J Neurosci 2009;119:2274–2279.CrossRefGoogle ScholarPubMed
8.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 Psychiatry 2005;50:703–714.Google Scholar
9.Sharma, V. Treatment-emergent tardive dyskinesia with quetiapine in mood disorders. J Clin Psychopharmacol 2003;23:415–417.CrossRefGoogle ScholarPubMed
10.Burris, KD, Molski, TF, Xu, Cet al. Aripiprazole, a novel antipsychotic, is a high-affinity partial agonist at human dopamine D2 receptors. J Pharmacol Exp Ther 2002;302:381–389.Google Scholar
11.Duggal, HS. Aripiprazole-induced improvement in tardive dyskinesia. Can J Psychiatry 2003;48:771–772.CrossRefGoogle ScholarPubMed
12.Eskow, KL, Gupta, V, Alam, S, Park, JY, Bishop, C. The partial 5-HT(1A) agonist buspirone reduces the expression and development of l-DOPA-induced dyskinesia in rats and improves l-DOPA efficacy. Pharmacol Biochem Behav 2007;87:306–314.Google Scholar
13.Barone, DA, Raniolo, J. Facial dyskinesia from overdose of an antihistamine. N Engl J Med 1980;303:107.Google Scholar
14.Jeste, DV, Doongaji, DR, Linnoila, M. Elevated cerebrospinal fluid noradrenaline in tardive dyskinesia. Br J Psychiatry 1984;144:177–180.Google Scholar
15.Yovtcheva, SP, Stanley-Tilt, C, Moles, JK. Reemergence of tardive dyskinesia after discontinuation of clozapine treatment. Schizophr Res 2000;46:107–109.Google Scholar
16.Chan, HY, Lin, WW, Lin, SKet al. Efficacy and safety of aripiprazole in the acute treatment of schizophrenia in Chinese patients with risperidone as an active control: a randomized trial. J Clin Psychiatry 2007;68:29–36.Google Scholar
17. Aripiprazole improves neuroleptic-associated tardive dyskinesia, but it does not meliorate psychotic symptoms. Prog Neuropsychopharmacol Biol Psychiatry 2008;32:1342–1343.CrossRefGoogle Scholar
18.Bhoopathi, PS, Soares-Weiser, K. Benzodiazepines for neuroleptic-induced tardive dyskinesia. The Cochrane database of systematic reviews 2006:CD000205.Google Scholar
19.Soares-Weiser, K, Maayan, N, McGrath, J. Vitamin E for neuroleptic-induced tardive dyskinesia. The Cochrane database of systematic reviews 2011:CD000209.Google Scholar
20.Soares-Weiser, KV, Joy, C. Miscellaneous treatments for neuroleptic-induced tardive dyskinesia. Cochrane Database Sys Rev 2003:CD000208.Google Scholar