A Case Report of Effect of Clozapine for Risperidone-Induced Tardive Dyskinesia

Oh, Seoung Jun; An, Suk Kyoon; Kwon, Young Sam; Lee, Hong Shick

Abstract

We experienced one case of treatment of clozapine for neuroleptic-induced tardive dyskinesia which was developed during low-dose risperidone treatment. The patient was a 22-year-old man with a 2-year history of schizophrenia. While he was taking 4-6 mg/d of Risperidone, he was capable of carrying a normal daily routine. But, after 11 months of taking risperidone(3 mg/d), dyskinetic movements had developed on his neck, trunk, and mainly on the right upper extremity. Simultaneously, his symptoms such as anxiety, persecutory delusion, and auditory hallucination were aggravated. Despite of adding the clonazepam(1 mg/d), no improvement of dyskinetic movements were observed. Then, we decreased the dose of risperidone and decided to switch the drug treatment from risperidone to clozapine. On admission, the total AIMS was 26 points (severe degree) and the total BPRS was 50 points. On the 9th day of the clozapine(100 mg/d) treatment, there were significant improvements in psychotic symptoms and dyskinetic movements(moderate degree). Then, we increased the dose of clozapine up to 350 mg/d on the 4th week. By then, the AIMS and the BPRS were 10 and 13 points respectively.