Multiple therapies relieve long-term tardive dyskinesia in a patient with chronic schizophrenia:A case report  

作　　者：Liang Lv Ping Guo Min Feng Yu Fang Shi-Kai Wang Huan-Xin Chen 

机构地区：[1]Department of Psychiatry,Huzhou Third People's Hospital Affiliated to Huzhou University,Huzhou 313000,Zhejiang Province,China [2]Key Laboratory,Huzhou Third People's Hospital Affiliated to Huzhou University,Huzhou 313000,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2023年第32期7895-7899,共5页世界临床病例杂志

基　　金：Science and Technology Program of Huzhou City,No.2023GYB32.

摘　　要：BACKGROUND Tardive dyskinesia(TD)is a serious and disabling movement disorder;it impairs social function and quality of life and increases the mortality rate.TD is usually induced by the use of antipsychotic drugs;however,the underlying mechanism remains unclear.Pharmacotherapy of TD includes cholinergic drugs,benzodiazepines,ginkgo biloba extract(GBE),antioxidants,amantadine,propanolol,botulinum toxin,valbenazine,and deutetrabenazine,whereas the non-pharmacotherapy approach includes modified electroconvulsive therapy(MECT)and deep brain stimulation.We successfully treated a chronic schizophrenia patient with comorbid long-term severe TD using deutetrabenazine,clozapine,and MECT.CASE SUMMARY A 69-year-old woman who was diagnosed as having schizophrenia 16 years ago developed severe TD after 6-mo prescription of risperidone oral solution.Her TD symptoms did not resolve despite various treatments,such as GBE,vitamin E,trihexyphenidyl,promethazine,benzodiazepines,and switching to quetiapine and olanzapine.After admission,she was given deutetrabenazine 6 mg bid.Her buccal tremor was slightly resolved 3 d later;however,her tongue remained protruded and could not be retracted.Quetiapine was switched to clozapine on day 4,and the buccal tremor remarkably resolved,and the tongue could be retracted into the mouth from day 6 onward.After three sessions of MECT,the buccal tremor resolved further.Since then,she has been able to take a semifluid diet,and her quality of life improved remarkably during 6 mo of follow-up.CONCLUSION TD is a serious condition which could be caused by antipsychotic medications;however,the best strategy against TD is prevention and monitoring during using antipsychotics.For patients with TD caused by antipsychotic medication use,multiple measures should be considered like switching to clozapine,adjunction with deutetrabenazine,or even MECT.

关 键 词：Tardive dyskinesia ANTIPSYCHOTICS CLOZAPINE Deutetrabenazine Electroconvulsive therapy Case report 

分 类 号：R733.3[医药卫生—肿瘤]