clozapine and Adjustment-Disorders

Tardive dyskinesia (TD) is still a severe side effect induced by old neuroleptic drugs as well as modern atypical ones. The treatment is inefficient and often experimental. Aim of this study was to examine the effect of pramipexole, a dopamine D3 receptor agonist, in a severe case of oro-facial TD.. The TD of a 21 year old male patient with severe oro-facial occurrence was assessed by the Simpson et al scale before starting pramipexole therapy. Reevaluation was made during therapy and when the maximum dose of 1.44 mg a day was reached. Standard therapy with clozapine, valproic acid, oxazepam, bornaprin hydrochlorid and tiapride was continued as before.. Oral dyskinesia decreased 20 % and no side effects were observed. Regarding psychopathology the patient was more interested in work and showed better concentration in therapies.. Pramipexole could be a new promising add-on therapy in severe TD. Additionally, the low plasma binding and mild side effect profile of pramipexole makes it safe in combination with antipsychotic therapy.

Topics: Adjustment Disorders; Aggression; Antipsychotic Agents; Benzothiazoles; Clozapine; Dopamine Agonists; Dose-Response Relationship, Drug; Drug Therapy, Combination; Dyskinesia, Drug-Induced; Humans; Intellectual Disability; Male; Pramipexole; Receptors, Dopamine D3; Social Behavior Disorders; Young Adult

The development of severe tardive dystonia after short-term use of low-dose Fluspirilen is described. A 39-year-old woman was treated with Fluspirilen IM by her family doctor for reactive depression. She did received no other neuroleptic agents and no risk factors for the development of tardive dyskinesia (e.g. old age or organic brain damage) were present. For the first time a relation between short-term monotherapy with Fluspirilen and tardive dyskinesia appears highly probable. The use of Fluspirilen for the treatment of psychogenic disturbances should therefore be considered carefully.

Topics: Adjustment Disorders; Adult; Clozapine; Dose-Response Relationship, Drug; Drug Administration Schedule; Dyskinesia, Drug-Induced; Dystonia; Female; Fluspirilene; Humans; Neurologic Examination