Open AccessMotor worsening and tardive dyskinesia with aripiprazole in Lewy body dementia
Author(s) -
Laura S. Boylan,
Scott Hirsch
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.06.2008.0205
Subject(s) - tardive dyskinesia , parkinsonism , aripiprazole , dyskinesia , medicine , discontinuation , antipsychotic , dementia , antipsychotic agent , neuroleptic malignant syndrome , extrapyramidal symptoms , movement disorders , lewy body , dopamine receptor , psychiatry , anesthesia , dopamine , schizophrenia (object oriented programming) , parkinson's disease , disease
Aripiprazole (APZ) is a novel antipsychotic agent which does not block dopamine (DA) receptors but is rather a partial DA agonist. Thus, it has been proposed that APZ may not induce tardive dyskinesia (TD), a disfiguring and sometimes disabling and irreversible side effect of neuroleptics. Our patient had Lewy body dementia (LBD) and developed severe worsening of parkinsonism over 1 month of APZ treatment. Within days of discontinuation of APZ dramatic orobuccal dyskinesias emerged. Treatment emergent worsening of parkinsonism improved but orobuccal dyskinesias persisted unchanged until his death 8 months later. Others have reported severe extrapyramidal reactions including neuroleptic malignant syndrome and TD with APZ. APZ has been suggested as a treatment for TD but treatment benefit may reflect "masked" dyskinesia. We conclude that, despite an attractive in vitro profile and promising animal data, APZ can induce serious extrapyramidal side effects, including TD.