Selfani Karim, Soland Valérie L, Chouinard Sylvain, Huot Philippe
*Unité des Troubles du Mouvement André Barbeau †Division of Neurology, Centre Hospitalier de l'Université de Montréal Departments of ‡Neuroscience §Pharmacology, Université de Montréal ∥Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Neurologist. 2017 Jan;22(1):24-28. doi: 10.1097/NRL.0000000000000096.
Aripiprazole is an antipsychotic that acts as a partial agonist at dopamine D2 receptors. Because of its partial agonist activity, it was believed that aripiprazole would be less susceptible than typical antipsychotics to induce extrapyramidal side effects. However, a few case-reports and case-series detailing aripiprazole-induced movement disorders have been published, suggesting that aripiprazole-induced movement disorders may arise. Here, we seek to report further cases of aripiprazole-induced movement disorders to raise the awareness of clinicians on this adverse effect.
Patients referred to the André-Barbeau Movement Disorder clinic treated with aripiprazole were enrolled in this study. Their charts were retrospectively reviewed and data regarding past psychiatric history, past antipsychotic medication, duration of aripiprazole treatment, daily dose of aripiprazole administered, and resulting movement disorders were collected.
We report 14 cases of parkinsonism, tardive dyskinesia and akathisia induced by aripiprazole. Some of these, mostly the parkinsonian phenotype, abated spontaneously following drug discontinuation, whereas others, mostly related to tardive phenomena, persisted after aripiprazole was discontinued, and required treatment.
This case-series adds to the existing literature that suggests that movement disorders may arise following treatment with aripiprazole. Clinicians should be aware of this potential side effect when prescribing aripiprazole to patients.
阿立哌唑是一种抗精神病药物,作为多巴胺D2受体的部分激动剂。由于其部分激动剂活性,人们认为阿立哌唑比典型抗精神病药物更不易诱发锥体外系副作用。然而,已经发表了一些详细描述阿立哌唑所致运动障碍的病例报告和病例系列,提示可能会出现阿立哌唑所致运动障碍。在此,我们试图报告更多阿立哌唑所致运动障碍的病例,以提高临床医生对这种不良反应的认识。
纳入在安德烈 - 巴博运动障碍诊所接受阿立哌唑治疗的患者。对他们的病历进行回顾性审查,并收集有关既往精神病史、既往抗精神病药物使用情况、阿立哌唑治疗持续时间、阿立哌唑每日给药剂量以及由此产生的运动障碍的数据。
我们报告了14例由阿立哌唑引起的帕金森综合征、迟发性运动障碍和静坐不能。其中一些,主要是帕金森病表型,在停药后自发缓解,而其他一些,主要与迟发性现象有关,在阿立哌唑停药后仍然存在,需要治疗。
这个病例系列补充了现有文献,表明使用阿立哌唑治疗后可能会出现运动障碍。临床医生在给患者开阿立哌唑处方时应意识到这种潜在的副作用。