Acute dystonia with low-dosage aripiprazole in Tourette's disorder.
OBJECTIVE
To report a case of an acute dystonic episode in a patient with Tourette's disorder (TD) treated with the partial dopamine agonist aripiprazole.


METHODS
An 18-year-old male with TD was prescribed aripiprazole 10 mg orally daily, which produced a significant improvement in his symptoms. However, after 3 days of treatment, he experienced an acute episode of dystonia with facial muscle spasm, oculogyric crisis, and torticolis. All symptoms resolved after a single intramuscular injection of biperidine 5 mg. The Naranjo probability scale indicated that the adverse events were probably caused by aripiprazole.


CONCLUSIONS
To our knowledge, as of this writing, this is the first report concerning an aripiprazole-induced dystonic episode in an adult, and it is especially notable because it occurred at low dosage. Aripiprazole is a dopamine partial agonist and a serotonin(2A) antagonist with a favorable adverse effect profile. Short-term clinical trials reported a very low incidence of extrapyramidal symptoms, with akathisia being the most common, although there have been reports of severe extrapyramidal symptoms in a 3-year-old child and in an adolescent with a previous history of such symptoms.


CONCLUSIONS
Acute dystonic phenomena may be caused by aripiprazole, although the drug's suggested mode of action largely precludes them.
Laboratory of Psychophysiology, Third Department of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, Greece. kfount@med.auth.gr
Konstantinos N
KN
Fountoulakis
Melina
M
Siamouli
Sotiris
S
Kantartzis
Panagiotis
P
Panagiotidis
Apostolos
A
Iacovides
George St
GS
Kaprinis
D000208:Acute Disease; D000293:Adolescent; D000068180:Aripiprazole; D001712:Biperiden / Q000627:therapeutic use; D004421:Dystonia / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D008297:Male; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015363:Quinolones / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005879:Tourette Syndrome / Q000188:drug therapy*; D016896:Treatment Outcome
D010879:Piperazines; D015363:Quinolones; D001712:Biperiden; D000068180:Aripiprazole