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Yıl:2020; Cilt: 33; Sayı: 4>> Özet
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Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi; 2020;33(4):429-432
10 yaşında bir erkek çocukta risperidona bağlı tardif distoni ve aripiprazolün etkinliği: bir olgu sunumu
A U Cicek, C Hocaoglu, T Ozmen
Cumhuriyet University, Sivas
Tardif distoni (TDt), esas olarak dopamin reseptör antagonistlerinin uzun süreli kullanımından kaynaklanan ekstrapiramidal sendromlardan biridir. Her ne kadar erişkinlerde risperidona bağlı TDt olguları bildirilmiş olsa da, çocuklarda az sayıda olgu sunumu ve klinik anekdot vardır. Tedavide ilk adım, TDt'ye neden olan ilacın kontrollü bir şekilde kesilmesi ve gerekirse, yeni, "atipik" antipsikotiklerden birine geçiştir. Bu yazıda huzursuzluk, saldırganlık, kendine zarar verme, bacak ve kalçada kasılma nedeni ile başvuran, orta düzeyde zihinsel gelişim geriliği ve davranım bozukluğu tanılı 10 yaşındaki bir erkek çocukta risperidona bağlı tardif distoni ve aripiprazolün etkinliği sunulmaktadır. Çocuğun distonik semptomları ve zorlayıcı davranışları aripiprazol uygulamasından yaklaşık 3 ay sonra tamamen iyileşmiştir. Çocuklarda uzun süreli antipsikotik kullanımının giderek yaygınlaştığı göz önüne alındığında, TDt periyodik olarak değerlendirilmeli ve izlenmelidir. Ayrıca aripiprazol, çocuklarda gelişen TDt tedavisinde uygun bir seçenek olabilir.
Risperidone-induced tardive dystonia in a 10 years old boy and the efficacy of aripiprazole: a case report
Tardive dystonia (TDt) is one of the extrapyramidal syndromes caused primarily by long-term use of dopamine receptor antagonists such as antipsychotics. Although the risperidone-induced TDt cases have been reported in adults, there are few case reports and clinical anecdotes in children. The first step in treatment is the controlled withdrawal of the drug causing the TDt and, if necessary, a transition to a newer “atypical” antipsychotic class. In this article, we present a case of risperidone-induced tardive dystonia and the efficacy of aripiprazole in a 10-years-old boy with moderate mental retardation and conduct disorder referred to us due to restlessness, aggression, self-mutilation, and leg and hip spasms. The child’s dystonic symptoms and challenging behaviors almost fully recovered 3 months of after the aripiprazole administration. Given that the long-term use of antipsychotics in children is increasingly widespread, TDt should be evaluated and monitored periodically. Furthermore, aripiprazole may be a suitable substitute in the TDt treatment in children.

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