Choe Young Min, Kim So Yeon, Choi Ihn-Geun, Suh Guk-Hee, Lee Dong Young, Lee Boung Chul, Kim Jee Wook
Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Korea.
Clin Psychopharmacol Neurosci. 2020 Nov 30;18(4):627-630. doi: 10.9758/cpn.2020.18.4.627.
Tardive dystonia and tardive dyskinesia (TDs) are rare extrapyramidal side effects that develop after long-term use of antipsychotics, but they are different syndromes and rarely occur at the same time. Olanzapine is an atypical antipsychotic drug associated with a low risk of extrapyramidal side effects in schizophrenia, but its associations with tardive movements are not clear. We present a case of a 19-year-old Asian female patient with schizophrenia and intellectual disabilities who developed concurrent TDs after long-term use of olanzapine. At her 10-month follow-up examination, her concurrent TDs had been treated successfully with clozapine. This case demonstrates that although the use of olanzapine to treat psychosis and behavioral disturbances is increasing due to its high efficacy and low rate of extrapyramidal side effects, concurrent TDs should be carefully assessed after long-term use of this antipsychotic, especially in patients with schizophrenia and intellectual disabilities. Clozapine, by preventing or reversing the debilitating consequences of concurrent TDs, may be an effective treatment for these patients.
迟发性肌张力障碍和迟发性运动障碍是长期使用抗精神病药物后出现的罕见锥体外系副作用，但它们是不同的综合征，很少同时发生。奥氮平是一种非典型抗精神病药物，在精神分裂症患者中发生锥体外系副作用的风险较低，但其与迟发性运动的关联尚不清楚。我们报告一例19岁患有精神分裂症和智力障碍的亚洲女性患者，长期使用奥氮平后并发迟发性运动障碍。在她10个月的随访检查中，其并发的迟发性运动障碍已通过氯氮平成功治疗。该病例表明，尽管由于奥氮平疗效高且锥体外系副作用发生率低，其用于治疗精神病和行为障碍的情况正在增加，但长期使用这种抗精神病药物后，尤其是对于患有精神分裂症和智力障碍的患者，应仔细评估是否并发迟发性运动障碍。氯氮平通过预防或逆转并发迟发性运动障碍的衰弱后果，可能是这些患者的有效治疗方法。
