Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Gen Hosp Psychiatry. 2012 Sep-Oct;34(5):578.e5-6. doi: 10.1016/j.genhosppsych.2011.11.001. Epub 2011 Dec 9.
Tardive dyskinesia (TD) is generally considered the most severe extrapyramidal sequelae of antipsychotic treatments.
Case report.
We present a 20-year-old woman with previous treatment of risperidone 6-7 mg daily for approximately 4 years. She developed TD 2 years later after switching to paliperidone 9 mg daily. To the best of our knowledge, she is the first case report of having direct paliperidone-induced TD. Immediate treatments including paliperidone dose reduction to 6 mg daily, clonazepam 1.5 mg daily and trihexyphenidyl 2 mg daily were performed for 1 month, and her symptoms were relieved eventually after switching to clozapine 75 mg daily.
Although second-generation antipsychotics such as paliperidone are considered to have a lowered risk of developing TD, this case could bring awareness to clinicians of the possibility of TD with the use of any antipsychotics.
迟发性运动障碍(TD)通常被认为是抗精神病药物治疗最严重的锥体外系后遗症。
病例报告。
我们报告了一位 20 岁的女性,她之前每天接受利培酮 6-7 毫克治疗,大约 4 年后改用帕利哌酮 9 毫克每天。据我们所知,她是首例直接由帕利哌酮引起的 TD 病例。我们立即进行了治疗,包括将帕利哌酮剂量减少至每天 6 毫克、氯硝西泮每天 1.5 毫克和三己芬迪每天 2 毫克,持续了 1 个月,最终在改用氯氮平每天 75 毫克后,她的症状得到了缓解。
尽管第二代抗精神病药如帕利哌酮被认为发生 TD 的风险较低,但该病例提醒临床医生任何抗精神病药物都有可能引起 TD。