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Suppression of antipsychotic-induced tardive dyskinesia with aripiprazole in an elderly patient with bipolar I disorder

Published online by Cambridge University Press:  23 September 2013

Wei-Yi Wu ,
Hung-Yu Chan  and
Happy Kuy-Lok Tan
Wei-Yi Wu
Affiliation:
Department of Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan
Hung-Yu Chan*
Affiliation:
Department of Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan Department of Psychology, Chung Yuan Christian University, Chung-Li, Taiwan
Happy Kuy-Lok Tan
Affiliation:
Department of Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan
*
Hung-Yu Chan, Department of Psychiatry, Taoyuan Mental Hospital, 71, Long-show Street, 33058 Taoyuan city, Taiwan. Tel: +886 3 3698553; Fax: +886 3 3699498; E-mail: jan30@seed.net.tw
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Abstract

Introduction

Aripiprazole has a low risk for causing extrapyramidal syndrome and can remit neuroleptic-induced tardive dyskinesia (TD). Here, we presented a case in which TD was suppressed, but not cured, by long-term aripiprazole treatment.

Case

This 74-year-old male patient had bipolar I disorder and had developed TD many times after several antipsychotic treatments. The lowest chlorpromazine dose equivalent among the previous antipsychotic treatments was 25 mg/day of quetiapine. His TD always improved immediately after the dosage was shifted to aripiprazole. However, his insomnia or other psychiatric symptoms worsened the first three times when the treatment was shifted to aripiprazole, making the transition a failure. Before the fourth attempt of aripiprazole transition, the patient was in a euthymic state but again developed TD under olanzapine 10 mg/day treatment. During the fourth attempt of aripiprazole transition, his TD had remained in complete remission for more than 1 year after the dosage shifted to 10 mg/day of aripiprazole. He developed TD again when we tapered the aripiprazole dose to 5 mg/day, but his TD remitted when we restored his aripiprazole dose to 10 mg/day.

Conclusion

Aripiprazole could be an effective drug in elderly bipolar patients with antipsychotic-induced TD while the patients are in a euthymic state. However, aripiprazole may only suppress TD rather than cure it.

Keywords

antipsychoticaripiprazolebipolar disordertardive dyskinesia
Type
Case Report
Information
Acta Neuropsychiatrica , Volume 26 , Issue 1 , February 2014 , pp. 61 - 64
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2013 

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