Acute Laryngeal Dystonia With Novel Antipsychotics

Ganesh, Malini; Jabbar, Umair; Iskander, Fady

doi:10.1097/jcp.0000000000000376

Cited by 13 publications

(23 citation statements)

References 8 publications

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“…However, there is also some evidence that antipsychotics reduce intelligibility of speech and induce poverty of speech 20,21 . Antipsychotics can also cause acute laryngeal dystonia 54 or laryngeal dyskinesia 55 , causing stridor and thereby negatively impacting speech. Furthermore, in Huntington's disease 56 , research shows that antipsychotic medication decreases speech rate and induces excessive loudness and pitch deviations.…”

Section: Discussionmentioning

confidence: 99%

Language disturbances in schizophrenia: the relation with antipsychotic medication

et al. 2020

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Language disturbances are key aberrations in schizophrenia. Little is known about the influence of antipsychotic medication on these symptoms. Using computational language methods, this study evaluated the impact of high versus low dopamine D2 receptor (D2R) occupancy antipsychotics on language disturbances in 41 patients with schizophrenia, relative to 40 healthy controls. Patients with high versus low D2R occupancy antipsychotics differed by total number of words and type-token ratio, suggesting medication effects. Both patient groups differed from the healthy controls on percentage of time speaking and clauses per utterance, suggesting illness effects. Overall, more severe negative language disturbances (i.e. slower articulation rate, increased pausing, and shorter utterances) were seen in the patients that used high D2R occupancy antipsychotics, while less prominent disturbances were seen in low D2R occupancy patients. Language analyses successfully predicted drug type (sensitivity = 80.0%, specificity = 76.5%). Several language disturbances were more related to drug type and dose, than to other psychotic symptoms, suggesting that language disturbances may be aggravated by high D2R antipsychotics. This negative impact of high D2R occupancy drugs may have clinical implications, as impaired language production predicts functional outcome and degrades the quality of life.

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Section: Discussionmentioning

confidence: 99%

Language disturbances in schizophrenia: the relation with antipsychotic medication

et al. 2020

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“…Historically, ALD is exceedingly rare and generally associated with the use of typical antipsychotics. 4,5 Only five documented cases of ALD resulting from atypical antipsychotics have been reported in the literature. 5 With increased transition from typical to atypical agents, reduction in the incidence of ALD is expected.…”

Section: Psychiatrymentioning

confidence: 99%

“…4,5 Only five documented cases of ALD resulting from atypical antipsychotics have been reported in the literature. 5 With increased transition from typical to atypical agents, reduction in the incidence of ALD is expected. However, in some Emergency Departments the use of typical agents for psychotic agitation remains mainstay.…”

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confidence: 99%

Acute laryngeal dystonia: a persisting psychiatric emergency

May

Al‐Taie

Garg

2016

Australas Psychiatry

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“…Most case reports on ALD have been associated with use of typical antipsychotics [14]. Nonetheless, a growing body of evidence suggests a correlation with use of newer atypical agents, particularly risperidone [15]. Although the underlying mechanism responsible for ALD remains unclear, one hypothesis postulates paradoxical adduction of the vocal cords during inspiration, leading to upper-airway obstruction [15].…”

Section: Discussionmentioning

confidence: 99%

Risperidone-Induced Acute Laryngeal Dystonia: A Case Report

Alkharboush

Alsalamah

2020

Am J Case Rep

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Unusual clinical course Background:Antipsychotic medications are associated with multiple adverse effects, including metabolic syndrome, prolonged QT interval, and extrapyramidal symptoms. Acute laryngeal dystonia (ALD) is a rare and lethal form of extrapyramidal reaction. Case Report:A 27-year-old woman with schizophrenia on risperidone presented to our Emergency Department with a sensation of choking and respiratory distress, mimicking a panic attack. She developed a generalized dystonic reaction in the hospital, leading to diagnosis risperidone-associated ALD as a cause of her initial problems. She was discharged with an emphasis on being compliant with anticholinergic medication. However, her persistent respiratory symptoms prompted us to revisit the management plan. Her risperidone dose was tapered down to discontinue and an alternate drug was chosen. Conclusions:ALD must be considered as a differential diagnosis when patients on antipsychotic medications present with respiratory distress. Our case highlights the association of ALD with an atypical antipsychotic agent, risperidone. Prompt recognition of this entity is necessary to prevent complications and guide definitive management.

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Acute Laryngeal Dystonia With Novel Antipsychotics

Cited by 13 publications

References 8 publications

Language disturbances in schizophrenia: the relation with antipsychotic medication

Language disturbances in schizophrenia: the relation with antipsychotic medication

Acute laryngeal dystonia: a persisting psychiatric emergency

Risperidone-Induced Acute Laryngeal Dystonia: A Case Report

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