Top-Up Clozapine for Risperidone LAI-Related Acute Dystonia and TR Bipolar in an Adolescent with ID-Putting the Cart before the Horse?

Q3 Medicine Psychopharmacology bulletin Pub Date : 2022-05-31

Ahmed Naguy, Saxby Pridmore, Anubhuti Singh, Bibi Alamiri

{"title":"Top-Up Clozapine for Risperidone LAI-Related Acute Dystonia and TR Bipolar in an Adolescent with ID-Putting the Cart before the Horse?","authors":"Ahmed Naguy, Saxby Pridmore, Anubhuti Singh, Bibi Alamiri","doi":"","DOIUrl":null,"url":null,"abstract":"Objectives: Young patients with intellectual disability (ID) have both diagnostic and therapeutic challenges. These include, inter alia, diagnostic overshadowing, diagnostic slippage and heightened vulnerability to adverse drug reactions. These would portent a generally poor prognostication.Methods: This is a case-study of an adolescent with intellectual disability long-hospitalized for co-morbid treatment-resistant bipolar mood disorder that failed to respond to ECT. Patient partially responded to LAI risperidone with repeated ADRs. Top-up with low-dose clozapine (100 mg/d) was pursued.Results: Low-dose clozapine top-up complemented therapeutic response (mood lability and paranoia) and strikingly safeguarded effectively against risperidone-related extrapyramidal side effects.Conclusions: Add-on clozapine remains a viable option, albeit off-label, in young patients with ID and treatment-resistant affective/schizophreniform psychoses. Clozapine has an edge over other agents in the setting of dyskinesias.","PeriodicalId":21069,"journal":{"name":"Psychopharmacology bulletin","volume":"52 2","pages":"161-164"},"PeriodicalIF":0.0000,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9172559/pdf/PB-52-2-161.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychopharmacology bulletin","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: Young patients with intellectual disability (ID) have both diagnostic and therapeutic challenges. These include, inter alia, diagnostic overshadowing, diagnostic slippage and heightened vulnerability to adverse drug reactions. These would portent a generally poor prognostication.

Methods: This is a case-study of an adolescent with intellectual disability long-hospitalized for co-morbid treatment-resistant bipolar mood disorder that failed to respond to ECT. Patient partially responded to LAI risperidone with repeated ADRs. Top-up with low-dose clozapine (100 mg/d) was pursued.

Results: Low-dose clozapine top-up complemented therapeutic response (mood lability and paranoia) and strikingly safeguarded effectively against risperidone-related extrapyramidal side effects.

Conclusions: Add-on clozapine remains a viable option, albeit off-label, in young patients with ID and treatment-resistant affective/schizophreniform psychoses. Clozapine has an edge over other agents in the setting of dyskinesias.

微信好友朋友圈 QQ好友复制链接

本刊更多论文

补充氯氮平治疗青少年id患者与利培酮相关的急性肌张力障碍和TR双相障碍，本末倒置?

目的:年轻智障患者在诊断和治疗方面都面临挑战。除其他外，这些包括诊断掩盖、诊断失误和对药物不良反应的脆弱性增加。这些将预示着一个普遍不佳的预测。方法:这是一个案例研究的智力残疾青少年长期住院共病治疗难治性双相情绪障碍，未能响应ECT。患者对LAI利培酮有部分反应，但反复出现不良反应。补充低剂量氯氮平(100mg /d)。结果:低剂量氯氮平补充补充了治疗反应(情绪不稳定和偏执)，并显著有效地预防了利培酮相关的锥体外系副作用。结论:对于患有ID和难治性情感性/精神分裂样精神病的年轻患者，添加氯氮平仍然是一种可行的选择，尽管在标签外。氯氮平在治疗运动障碍方面比其他药物更有优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊