Positive response to clozapine augmentation in a patient with obsessive-compulsive disorder complicated by a tardive movement disorder

Baptista, Trino; León, José de

doi:10.1590/1516-4446-2017-2565

Cited by 5 publications

(1 citation statement)

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“…Parkinson’s disease, bipolar disorder, obsessive-compulsive disorder) which can also develop TD as a side effect to medication use. For example, two recent case reports highlight the efficacy of augmentation with low-dose clozapine (50 mg/d) to improve symptoms of TD, in patients diagnosed with obsessive-compulsive disorder (Baptista and Araujo, 2019; Baptista and de Leon, 2018). Although clozapine administration for other clinical populations such as this one constitutes off-label use, future studies should determine the benefits of clozapine administration in these individuals which may also develop TD.…”

Section: Discussionmentioning

confidence: 99%

Clozapine and tardive dyskinesia in patients with schizophrenia: A systematic review

et al. 2019

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Background: It is commonly recommended that a switch to clozapine be implemented in the face of tardive dyskinesia, even if current treatment involves another “atypical” agent. However, reports do indicate clozapine carries a liability for tardive dyskinesia. Aims: This review sought to evaluate clozapine in relation to tardive dyskinesia in the context of available evidence. Methods: Medline, Embase, and PsycINFO databases were searched for studies published in English, using the keywords: clozapine AND tardive dyskinesia OR TD. References from major review articles were searched for additional relevant publications. Studies were included if they investigated: tardive dyskinesia in clozapine-treated patients diagnosed with schizophrenia spectrum disorders, and reported on two or more assessments of tardive dyskinesia severity measured by the Abnormal Involuntary Movement Scale; or clozapine’s tardive dyskinesia liability. Results: In total, 513 unique citations were identified and 29 reports met the inclusion criteria. Thirteen studies suggest clozapine reduces dyskinetic symptoms over time ( n=905 clozapine-treated participants); however, the minimum required dose and effect of withdrawal requires further investigation. The majority of reports which address clozapine’s liability for tardive dyskinesia are case studies (11 of 14 reports, 79%), and clozapine was only the first-line treatment in one of the remaining three studies reporting treatment-emergent dyskinetic symptoms with clozapine in 12% of patients. No significant between-drug differences were identified comparing clozapine’s risk to other atypical antipsychotics. Conclusions: Research to date supports switching to clozapine for the purpose of reducing tardive dyskinesia risk and/or treating existing tardive dyskinesia, but prospective randomized controlled trials are necessary if we are to substantiate existing recommendations.

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Section: Discussionmentioning

confidence: 99%