[D3 agonism: an augmentative treatment in tardive dyskinesia? A case report].
OBJECTIVE
Tardive dyskinesia (TD) is still a severe side effect induced by old neuroleptic drugs as well as modern atypical ones. The treatment is inefficient and often experimental. Aim of this study was to examine the effect of pramipexole, a dopamine D3 receptor agonist, in a severe case of oro-facial TD.


METHODS
The TD of a 21 year old male patient with severe oro-facial occurrence was assessed by the Simpson et al scale before starting pramipexole therapy. Reevaluation was made during therapy and when the maximum dose of 1.44 mg a day was reached. Standard therapy with clozapine, valproic acid, oxazepam, bornaprin hydrochlorid and tiapride was continued as before.


RESULTS
Oral dyskinesia decreased 20 % and no side effects were observed. Regarding psychopathology the patient was more interested in work and showed better concentration in therapies.


CONCLUSIONS
Pramipexole could be a new promising add-on therapy in severe TD. Additionally, the low plasma binding and mild side effect profile of pramipexole makes it safe in combination with antipsychotic therapy.
Rehor
Gerald
G
LKH Rankweil Abteilung für Psychiatrie I, Rankweil/Osterreich. gerald@rehor.at
Eiler
Meinhard
M
Conca
Andreas
A
D000275:Adjustment Disorders / Q000188:drug therapy*; D000374:Aggression / Q000187:drug effects; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D052160:Benzothiazoles / Q000627:therapeutic use*; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy*; D006801:Humans; D008607:Intellectual Disability / Q000188:drug therapy*; D008297:Male; D000077487:Pramipexole; D050637:Receptors, Dopamine D3 / Q000819:agonists*; D012920:Social Behavior Disorders / Q000188:drug therapy*; D055815:Young Adult
D014150:Antipsychotic Agents; D052160:Benzothiazoles; D018491:Dopamine Agonists; D050637:Receptors, Dopamine D3; D000077487:Pramipexole; D003024:Clozapine