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.
Fountoulakis
Konstantinos N
KN
Laboratory of Psychophysiology, Third Department of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, Greece. kfount@med.auth.gr
Siamouli
Melina
M
Kantartzis
Sotiris
S
Panagiotidis
Panagiotis
P
Iacovides
Apostolos
A
Kaprinis
George St
GS
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