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Tardive Dyskinesia After Aripiprazole Treatment That Improved With Tetrabenazine, Clozapine, and Botulinum Toxin

We report on a patient with tardive dyskinesia (TDK) treated with aripiprazole, a third-generation antipsychotic with partial D2 agonist-antagonist activity at both the dopamine and serotonin receptors. The patient’s condition improved with administration of a combination of tetrabenazine, botulinum...

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Autores principales: Aguilar, Lourdes, Lorenzo, Carolina, Fernández-Ovejero, Raquel, Roncero, Carlos, Montejo, Angel L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435569/
https://www.ncbi.nlm.nih.gov/pubmed/30949057
http://dx.doi.org/10.3389/fphar.2019.00281
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author Aguilar, Lourdes
Lorenzo, Carolina
Fernández-Ovejero, Raquel
Roncero, Carlos
Montejo, Angel L.
author_facet Aguilar, Lourdes
Lorenzo, Carolina
Fernández-Ovejero, Raquel
Roncero, Carlos
Montejo, Angel L.
author_sort Aguilar, Lourdes
collection PubMed
description We report on a patient with tardive dyskinesia (TDK) treated with aripiprazole, a third-generation antipsychotic with partial D2 agonist-antagonist activity at both the dopamine and serotonin receptors. The patient’s condition improved with administration of a combination of tetrabenazine, botulinum toxin, and clozapine, which has previously not been used. We suggest that this treatment combination may have potential benefits for patients with TDK. After aripiprazole discontinuation, the patient was treated with clozapine (150 mg/day) and biperiden (8 mg/day). Due to a lack of improvement, we administered 300 units (intramuscularly; IM) of botulinum toxin into the paravertebral muscles every 3 months and 1,000 units IM every 4 months in addition to tetrabenazine (75 mg/day) and biperiden (8 mg/day). The patient stopped this treatment, at which point TDK reappeared. After starting a treatment regimen of clozapine (100 mg/day), tetrabenazine (75 mg/day), and botulinum toxin (300 units IM), the patient’s symptoms remitted.
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spelling pubmed-64355692019-04-04 Tardive Dyskinesia After Aripiprazole Treatment That Improved With Tetrabenazine, Clozapine, and Botulinum Toxin Aguilar, Lourdes Lorenzo, Carolina Fernández-Ovejero, Raquel Roncero, Carlos Montejo, Angel L. Front Pharmacol Pharmacology We report on a patient with tardive dyskinesia (TDK) treated with aripiprazole, a third-generation antipsychotic with partial D2 agonist-antagonist activity at both the dopamine and serotonin receptors. The patient’s condition improved with administration of a combination of tetrabenazine, botulinum toxin, and clozapine, which has previously not been used. We suggest that this treatment combination may have potential benefits for patients with TDK. After aripiprazole discontinuation, the patient was treated with clozapine (150 mg/day) and biperiden (8 mg/day). Due to a lack of improvement, we administered 300 units (intramuscularly; IM) of botulinum toxin into the paravertebral muscles every 3 months and 1,000 units IM every 4 months in addition to tetrabenazine (75 mg/day) and biperiden (8 mg/day). The patient stopped this treatment, at which point TDK reappeared. After starting a treatment regimen of clozapine (100 mg/day), tetrabenazine (75 mg/day), and botulinum toxin (300 units IM), the patient’s symptoms remitted. Frontiers Media S.A. 2019-03-20 /pmc/articles/PMC6435569/ /pubmed/30949057 http://dx.doi.org/10.3389/fphar.2019.00281 Text en Copyright © 2019 Aguilar, Lorenzo, Fernández-Ovejero, Roncero and Montejo. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Aguilar, Lourdes
Lorenzo, Carolina
Fernández-Ovejero, Raquel
Roncero, Carlos
Montejo, Angel L.
Tardive Dyskinesia After Aripiprazole Treatment That Improved With Tetrabenazine, Clozapine, and Botulinum Toxin
title Tardive Dyskinesia After Aripiprazole Treatment That Improved With Tetrabenazine, Clozapine, and Botulinum Toxin
title_full Tardive Dyskinesia After Aripiprazole Treatment That Improved With Tetrabenazine, Clozapine, and Botulinum Toxin
title_fullStr Tardive Dyskinesia After Aripiprazole Treatment That Improved With Tetrabenazine, Clozapine, and Botulinum Toxin
title_full_unstemmed Tardive Dyskinesia After Aripiprazole Treatment That Improved With Tetrabenazine, Clozapine, and Botulinum Toxin
title_short Tardive Dyskinesia After Aripiprazole Treatment That Improved With Tetrabenazine, Clozapine, and Botulinum Toxin
title_sort tardive dyskinesia after aripiprazole treatment that improved with tetrabenazine, clozapine, and botulinum toxin
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435569/
https://www.ncbi.nlm.nih.gov/pubmed/30949057
http://dx.doi.org/10.3389/fphar.2019.00281
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