Successful treatment of tardive dystonia with clozapine and clonazepam.
BACKGROUND
Tardive dystonia is an uncommon complication of neuroleptic treatment which is frequently disabling and poorly responsive to treatment.


METHODS
The case is reported of a 28-year-old patient with schizophrenia who developed severe, generalised tardive dystonia after five years of neuroleptic treatment. Stopping neuroleptic medication and treatment with tetrabenazine, an anticholinergic and a benzodiazepine were ineffective. Treatment with clozapine and then the novel combination of clozapine plus clonazepam was instituted.


RESULTS
Treatment with clozapine alone brought about limited improvement. Addition of clonazepam resulted in virtually complete disappearance of all abnormal movements. This remission has been sustained for nearly two years.


CONCLUSIONS
This report adds to two other cases suggesting that the combination of clozapine and clonazepam may be an effective treatment for tardive dystonia.
Shapleske
J
J
Department of Psychological Medicine, Kings College School of Medicine & Dentistry, London.
Mickay
A P
AP
Mckenna
P J
PJ
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D002998:Clonazepam / Q000627:therapeutic use*; D003024:Clozapine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004421:Dystonia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D009460:Neurologic Examination / Q000187:drug effects; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology
D000927:Anticonvulsants; D014150:Antipsychotic Agents; D002998:Clonazepam; D003024:Clozapine