Aripiprazole-Associated Acute Dystonia, Akathisia, and Parkinsonism in a Patient With Bipolar I Disorder

Chen, Mu‐Hong; Liou, Ying‐Jay

doi:10.1097/jcp.0b013e3182856826

Cited by 10 publications

(6 citation statements)

References 14 publications

(14 reference statements)

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“…In our patient, augmentation of levodopa/carbidopa worsened agitation and mania symptoms, as expected based on the above hypothesis. Besides, administration of aripiprazole (as a partial dopamine D2 receptor agonist) aggravated Parkinsonism, a complication mentioned in previous studies as well 2 . Olanzapine, however, was associated with a significant improvement in the patient's BD symptoms without exacerbating or inducing Parkinsonism.…”

Section: Discussionmentioning

confidence: 83%

Lewy body dementia in an elderly patient with bipolar disorder: Challenges and treatment options

Khosravi

2021

Bipolar Disorders

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In March 2020, a 62-year-old Iranian woman with bipolar I disorder was referred to the psychiatry outpatient clinic of the Ali Ibn Abi Talib Hospital, Zahedan, Iran, due to a depressive episode with psychotic features (and with mixed features), as well as the rise of Parkinsonism. The patient was first treated with lithium carbonate (300 mg three times a day) after being hospitalized due to a manic episode at the age of 24. After this, she remained euthymic for more than 30 years. However, there were a 15-year history of dreamenacting behaviors and nearly 2 years of cognitive fluctuations in the patient's past psychiatric history. During the recent episode, despite regular consumption of lithium carbonate (serum lithium concentrations of 0.8 mmol/L), she suffered from symptoms such as fluctuating cognition, depressed mood, feelings of worthlessness, markedly diminished interest, fatigue, significant weight loss, decreased need for sleep, increased talkativity, flight of ideas, persecutory delusion, and recurrent complex visual hallucinations. Moreover, resting tremor in 4-6 Hz range, bradykinesia, symmetric cogwheel rigidity in

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Section: Discussionmentioning

confidence: 83%

Lewy body dementia in an elderly patient with bipolar disorder: Challenges and treatment options

Khosravi

2021

Bipolar Disorders

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“… 6 Later, various studies demonstrated findings to support WM disturbances in patients with ADHD. 7 , 8 In these patients, both reduced and elevated FA values in comparison to controls have been reported. It has been suggested that reduced FA values seen in ADHD might be associated with axonal damage or delayed myelination, and elevated FA values might be related to decreased neuronal branching.…”

Section: Introductionmentioning

confidence: 69%

White matter alterations related to attention-deficit hyperactivity disorder and COMT val158met polymorphism: children with valine homozygote attention-deficit hyperactivity disorder have altered white matter connectivity in the right cingulum (cingulate gyrus)

Başay

Büber

Başay

et al. 2016

NDT

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IntroductionIn this article, the COMT gene val158met polymorphism and attention-deficit hyperactivity disorder (ADHD)-related differences in diffusion-tensor-imaging-measured white matter (WM) structure in children with ADHD and controls were investigated.Patients and methodsA total of 71 children diagnosed with ADHD and 24 controls aged 8–15 years were recruited. Using diffusion tensor imaging, COMT polymorphism and ADHD-related WM alterations were investigated, and any interaction effect between the COMT polymorphism and ADHD was also examined. The effects of age, sex, and estimated total IQ were controlled by multivariate analysis of covariance (MANCOVA).ResultsFirst, an interaction between the COMT val158met polymorphism and ADHD in the right (R) cingulum (cingulate gyrus) (CGC) was found. According to this, valine (val) homozygote ADHD-diagnosed children had significantly lower fractional anisotropy (FA) and higher radial diffusivity (RD) in the R-CGC than ADHD-diagnosed methionine (met) carriers, and val homozygote controls had higher FA and lower RD in the R-CGC than val homozygote ADHD patients. Second, met carriers had higher FA and axial diffusivity in the left (L)-uncinate fasciculus and lower RD in the L-posterior corona radiata and L-posterior thalamic radiation (include optic radiation) than the val homozygotes, independent of ADHD diagnosis. Third, children with ADHD had lower FA in the L-CGC and R-retrolenticular part of the internal capsule than the controls, independent of the COMT polymorphism.ConclusionSignificant differences reported here may be evidence that the COMT gene val158met polymorphism variants, as well as ADHD, could affect brain development. ADHD and the COMT polymorphism might be interactively affecting WM development in the R-CGC to alter the WM connectivity in children with val homozygote ADHD.

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“… 17 , 18) Compared to adults, children and adolescents more frequently experience EPS, but dystonic reactions are still quite rare. 19) There are reports of acute dystonia following treatment with aripiprazole at doses of 10 mg/day and above, 5 , 7 , 20 , 21) and aripiprazole-induced acute dystonia, particularly cases of torticollis, has been shown to be more frequent in young males. 22) Furthermore, male gender, younger age, cocaine abuse, a history of dystonia, and use of high-potency neuroleptics are known risk factors for the development of dystonia.…”

Section: Discussionmentioning

confidence: 99%

Acute Dystonia Following a Switch in Treatment from Atomoxetine to Low-dose Aripiprazole

Başay

Öztürk

2016

Clin Psychopharmacol Neurosci

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The present report describes the cases of a 17-year-old male patient and a 13-year-old female patient who developed acute dystonia following the administration of low-dose aripiprazole (5 mg/day) after the cessation of atomoxetine treatment. Although aripiprazole-induced dystonia has been previously reported in the literature, it is rare, and most of these cases were associated with doses higher than 5 mg/day. Furthermore, both of the patients in the present study discontinued atomoxetine prior to the initiation of aripiprazole treatment; thus, this report also discussed the possible mechanisms underlying the manifestation of dystonia from the perspective of neurotransmitter activity.

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Aripiprazole-Associated Acute Dystonia, Akathisia, and Parkinsonism in a Patient With Bipolar I Disorder

Cited by 10 publications

References 14 publications

Lewy body dementia in an elderly patient with bipolar disorder: Challenges and treatment options

Lewy body dementia in an elderly patient with bipolar disorder: Challenges and treatment options

White matter alterations related to attention-deficit hyperactivity disorder and COMT val158met polymorphism: children with valine homozygote attention-deficit hyperactivity disorder have altered white matter connectivity in the right cingulum (cingulate gyrus)

Acute Dystonia Following a Switch in Treatment from Atomoxetine to Low-dose Aripiprazole

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