Nishijima Haruo, Nishijima Miyuki, Oyama Chikyo, Tomiyama Masahiko
Neurology, Hirosaki University Graduate School of Medicine, Hirosaki, JPN.
Neurology, Hirosaki University Hospital, Hirosaki, JPN.
Cureus. 2024 Jul 23;16(7):e65223. doi: 10.7759/cureus.65223. eCollection 2024 Jul.
Atypical antipsychotics are considered to be better tolerated than typical antipsychotics; however, the risk of drug-induced movement disorders needs to be considered. Aripiprazole, a dopamine partial agonist, is one of the most frequently used atypical antipsychotics in children. In this report, we describe withdrawal dyskinesia after aripiprazole discontinuation in a child with autism spectrum disorder. The patient presented with oral dyskinesia after discontinuation of aripiprazole when he was 13 years old. Dyskinetic movements disappeared after reinitiation of aripiprazole. He developed oral dyskinesia again after a reduction of the aripiprazole dose when he was 14 years old. Dyskinesia gradually disappeared within a few months. Withdrawal dyskinesia associated with aripiprazole has been rarely reported in children. Moreover, there is no large study on the prevalence of dyskinesia associated with aripiprazole discontinuation either in adults or in children. However, relevant cases might be unreported, pretermitted, or regarded as akathisia or symptoms of attention-deficit hyperactivity disorder. The prevalence of withdrawal dyskinesia associated with aripiprazole, especially in children, may be more frequent than thought. Withdrawal dyskinesia is self-limited; however, such dyskinetic movements in children potentially result in irreversible effects that damage the quality of life. As such, physicians should be mindful when changing, reducing, or discontinuing antipsychotics in children.
非典型抗精神病药物被认为比典型抗精神病药物耐受性更好；然而，需要考虑药物引起的运动障碍风险。阿立哌唑，一种多巴胺部分激动剂，是儿童中最常用的非典型抗精神病药物之一。在本报告中，我们描述了一名自闭症谱系障碍儿童停用阿立哌唑后出现的撤药运动障碍。该患者13岁停用阿立哌唑后出现口部运动障碍。重新使用阿立哌唑后运动障碍消失。他14岁时阿立哌唑剂量减少后再次出现口部运动障碍。运动障碍在几个月内逐渐消失。与阿立哌唑相关的撤药运动障碍在儿童中很少有报道。此外，关于成人或儿童中与阿立哌唑停药相关的运动障碍患病率也没有大型研究。然而，相关病例可能未被报告、被忽略或被视为静坐不能或注意力缺陷多动障碍的症状。与阿立哌唑相关的撤药运动障碍的患病率，尤其是在儿童中，可能比想象的更常见。撤药运动障碍是自限性的；然而，儿童中的这种运动障碍可能会导致不可逆转的影响，损害生活质量。因此，医生在给儿童更改、减少或停用抗精神病药物时应予以注意。
