Mrs SR, aged 45 years, was initially diagnosed with bipolar disorder 16 years prior to this report and, more recently, with schizoaffective disorder, bipolar type. She took oral and then depot haloperidol for many years, along with lithium and then divalproex. For 6 years, she was consistently treated in our clinic with risperidone 4 mg and divalproex 2000 mg daily. On 3 occasions, she discontinued all medications, was admitted to the state hospital, and returned to our clinic taking haloperidol decanoate 100 mg intramuscularly every 3 weeks. Each time, we gradually returned her to the risperidone and divalproex combination. On the last occasion, when most recently changed from haloperidol to risperidone, she was noted to have mild TD and an Abnormal Involuntary Movement Scale (AIMS) score of 8. Clonazepam 1 mg daily was added with little improvement. For the next year and a half, her AIMS score varied between 7 and 9, with no trend toward improvement.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.