SYMPOSIA
SYMPOSIA
SYMPOSIA
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References:<br />
Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org<br />
Poster Presentations<br />
1. Segura-Bruna N, Rodriguez-Campello A, Puente V, Roquer J. Valproate-induced hyperammonemic encephalopathy. Acta Neurol Scand 2006; 114(1):1-7.<br />
2. Chen WT, Yen DJ, Yu HY, Liao KK. Valproate-induced encephalopathy. Zhonghua Yi Xue Za Zhi (Taipei) 2001; 64(8):474-8.<br />
3. Wadzinski J, Franks R, Roane D, Bayard M. Valproate-associated hyperammonemic encephalopathy. J Am Board Fam Med 2007; 20(5):499-502.<br />
4. Gurjar M, Singhal S, Baronia AK, Azim A, Poddar B. Valproate-induced hyperammonemic encephalopathy: A reminder of rare complication of valproate. J Emerg<br />
Trauma Shock 2011; 4(2):321-2.<br />
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S164-5<br />
[PP-074] Ref. No: 274<br />
Two cases of tardive dyskinesia associated with the use of paliperidone ER and<br />
their management<br />
Ömer Yanartaş, Yücel Yılmaz, İshak Saygılı, Selma Bozkurt Zincir, Ümit Başar Semiz<br />
Erenkoy Mental Health and Disorders Training and Research Hospital, Istanbul, Turkey<br />
E-mail: yanartas2005@yahoo.com<br />
Paliperidone is an extended-release (ER) medication used in the treatment of schizophrenia and the recommended dose range is 3-12<br />
mg/day (1). Tardive dyskinesia (TD) associated with the use of antipsychotics is characterized by involuntary choreic-athetoid movements<br />
occurring in the late stages of the treatment. Choreathetoid movements mostly occur around the mouth and face and athetoid<br />
movements alone mostly occur on the head-neck and pelvis (2, 3). We hereby present two cases of perioral dyskinesia who were using<br />
paliperidone, and discuss their response to the treatment.<br />
Both patients were females in their 20s and had been diagnosed with paranoid schizophrenia according to the DSM-IV-TR diagnostic<br />
criteria. Both patients had been using olanzapine before being switched to paliperidone ER. Olanzapine treatment had been discontinued<br />
due to side effects and treatment failure. The durations of paliperidone ER use were 9 months and 1 year, respectively; the doses of<br />
paliperidone ER were 9 and 12 mg/day that is consistent with the literature in terms of side effect risk (4). In one of the cases, the<br />
occurrence of side effects in combination with a psychotic exacerbation led to a change in antipsychotic drug therapy. In the other case,<br />
the drug was not discontinued due to the remission of initial psychotic symptoms and satisfaction of the patient with the treatment;<br />
however, the drug dose was reduced. In the treatment of TD associated with the use of paliperidone ER, one case responded to vitamin<br />
E 400 MU/day and omega 3 fatty acids while the other was administered propranolol 40 mg/day and clonazepam 1 mg/day. After one<br />
month, the scores of both patients on the extrapyramidal symptoms assessment scale were markedly reduced. The patient who had the<br />
psychotic exacerbation also had a history of childhood trauma, which we feel had negatively influenced the course of the treatment.<br />
Young age and female sex, and drug use for more than 6 months may increase the risk of TD in patients taking paliperidone; the use of<br />
vitamin E, omega 3 fatty acids, propranolol, and clonazepam may lead to a significant improvement in symptoms.<br />
Key words: Extrapyramidal side effects, paliperidone, tardive dyskinesia<br />
References:<br />
1. Janicak PG, Winans EA. Paliperidone ER: a review of the clinical trial data Neuropsychiatric Disease and Treatment 2007:3(6) 869–883.<br />
2. Kaplan HI, Sadock BJ Synopsis of Psychiatry: Eighth ed. Baltimore: Williams & Wilkins, 1998<br />
3. Bernstein JG. Drug Therapy in Psychiatry. Third ed. St.Louis: Mosby-Year Book, 1995<br />
4. Meltzer HY, Bobo WV, Nuamah IF, Lane R, Hough D, Kramer M, Eerdekens M. Efficacy and tolerability of oral paliperidone extended-release tablets in the treatment<br />
of acute schizophrenia: pooled data from three 6-week, placebo-controlled studies. J Clin Psychiatry 2008 May;69(5):817-29.<br />
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S165<br />
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