Treatment of phenothiazine induced bulbar persistent dyskinesia with deanol acetamidobenzoate.
The late manifestation of neuroleptic-induced dyskinesia (persistent dyskinesia) is an irreversible complication of long-term treatment that is poorly understood and difficult to treat. Recently, a theory of dopamine receptor hypersensitivity in the dopaminergic-cholinergic system has suggested an explanation of choreiform movements and, thus, an implication for the management of persistent dyskinesia. The case presented is that of bulbar persistent dyskinesia in a patient who had been prescribed a phenothiazine derivative for eleven years; his symptoms improved with the use of deanol, which probably converts to acetylcholine after crossing the blood brain barrier. This improvement suggests that deanol may shift the neuroleptic-induced dopaminergic-cholinergic system unbalance toward equilibrium by matching predominant dopaminergic effect or by enhancing deficient cholinergic action in the dopaminergic-cholinergic system. This isolated finding needs to be confirmed by more research in neuropharmacology.
D000081:Acetamides / Q000627:therapeutic use; D000328:Adult; D001565:Benzoates / Q000627:therapeutic use; D002746:Chlorpromazine / Q000009:adverse effects*; D003642:Deanol / Q000627:therapeutic use*; D004983:Ethanolamines / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000139:chemically induced / Q000188:drug therapy*; D014268:Trifluoperazine / Q000009:adverse effects*
D000081:Acetamides; D001565:Benzoates; D004983:Ethanolamines; D014268:Trifluoperazine; D003642:Deanol; D002746:Chlorpromazine