title: Treatment of Tardive Dystonia Induced by Antipsychotics, Old and New.
abstract: OBJECTIVE
  Tardive dystonia is a serious extrapyramidal side effect emerging after long-term treatment with antipsychotics, frequently with a deteriorating course, and unsatisfactory treatment. Presently, clozapine is used for the cotreatment of tardive dystonia and psychosis, at the cost of serious side effects. Apart from clozapine, there have been case reports describing positive effects of quetiapine on dystonic symptoms. Aim of the present study was to demonstrate the ameliorating effects of quetiapine on dystonic symptoms, in a sample of patients suffering from antipsychotic-induced tardive dystonia.
  
  
  METHODS
  Quetiapine was administered to 16 consecutively enrolled stabilized patients with psychotic or mood disorders and tardive dystonia, replacing the "offending drugs," over a 3-month cross-tapering period. Target dose of quetiapine was set according to the defined daily dose of the received antipsychotic(s) at baseline, as reviewed by the World Health Organization Center of Drug Statistics Methodology, aiming at both maintenance of psychosis control and reduction of dystonic symptoms.
  
  
  RESULTS
  Patients were found to have significant positive results in amelioration of dystonia (P < 0.001) over a 1-year period, without loss of antipsychotic efficacy. Reduction of dystonic symptoms with the use of quetiapine could be considered comparable with the positive effects of clozapine, with the additional advantage of relatively lacking serious side effects.
  
  
  CONCLUSIONS
  Quetiapine may represent a valuable therapeutic choice for the treatment of tardive dystonia.
authors.affiliation: *Department of Psychiatry, †Department of Psychiatry, and ‡Department of Neurology, General University Hospital of Patras, School of Medicine, University of Patras, Rio, Greece.
authors.forename: Philippos
authors.initials: P
authors.lastname: Gourzis
authors.forename: Maria
authors.initials: M
authors.lastname: Skokou
authors.forename: Evanthia
authors.initials: E
authors.lastname: Soubasi
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Katrivanou
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Polychronopoulos
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects*; D003024:Clozapine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000150:complications / Q000188:drug therapy* / Q000209:etiology*; D000069348:Quetiapine Fumarate / Q000627:therapeutic use*; D012189:Retrospective Studies; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000209:etiology
chemical_list: D014150:Antipsychotic Agents; D000069348:Quetiapine Fumarate; D003024:Clozapine