Evidence suggests atypical antipsychotic treatment is associated with a lower incidence of tardive dyskinesia (TD) than typical antipsychotic drugs, and is a potential antidyskinetic treatment. We present the case of a middle-aged woman never previously exposed to antipsychotic treatment who developed TD after 6 months of olanzapine monotherapy. Substitution of quetiapine for olanzapine alleviated her TD symptoms. The case demonstrates that atypical antipsychotic drugs have different effects in relation to TD. Potential psychopharmacological mechanisms explaining these differences are discussed, highlighting the importance of D2 receptor occupancy by atypical antipsychotic drugs for TD.
Get full access to this article
View all access options for this article.
References
1.
Alcohol Drug Abuse and Mental Health Administration (1974) Abnormal involuntary movement scale (AIMS). Department of Health, Education and Welfare, Washington, DC
2.
Almeida O P (1998) Olanzapine for the treatment of tardive dyskinesia . J Clin Psychiatry59: 380–381
3.
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn (DSM VI). American Psychiatric Press, Washington, DC
Barnes T R (1989) A rating scale for drug-induced akathisia . Br J Psychiatry154: 672–676
6.
Casey D E (1995) Tardive dyskinesia. In Borroni E, Kupfer D J (eds), Psychopharmacology: the fourth generation of progress, pp. 1497–1501. Raven Press Ltd, New York
7.
Casey D E (1999) Tardive dyskinesia and atypical antipsychotic drugs . Schizophr Res35 (Suppl): S61–S66
8.
Casey D E, Denney D (1977) Pharmacological characterization of tardive dyskinesia . Psychopharmacology (Berl)54: 1–8
9.
Gardos G, Cole J O (1995) The treatment of tardive dyskinesias. In Borroni E, Kupfer D J (eds), Psychopharmacology: the fourth generation of progress, pp. 1503–1511. Raven Press Ltd, New York
10.
Glazer W M, Morgenstern H, Doucette J T (1993) Predicting the long-term risk of tardive dyskinesia in outpatients maintained on neuroleptic medications . J Clin Psychiatry54: 133–139
11.
Jones H M, Travis M J, Mulligan R, Bressan R A, Visvikis D, Gacinovic S, Eu P J, Pilowsky L S (2001) In vivo 5-HT2 A receptor blockade by quetiapine: an R91150 single photon emission tomography study . Psychopharmacology (Berl)157: 60–66
12.
Kane J M (1995) Tardive dyskinesia: epidemiological and clinical presentation. In Borroni E, Kupfer D J (eds), Psychopharmacology: the fourth generation of progress, pp. 1485–1495. Raven Press Ltd, New York
13.
Kapur S, Seeman P (2001) Does fast dissociation from the dopamine d(2) receptor explain the action of atypical antipsychotics?: a new hypothesis . Am J Psychiatry158: 360–369
14.
Kapur S, Zipursky R B, Remington G (1999) Clinical and theoretical implications of 5-HT2 and D2 receptor occupancy of clozapine, risperidone, and olanzapine in schizophrenia . Am J Psychiatry156: 286–293
15.
Kapur S, Zipursky R, Jones C, Shammi C S, Remington G, Seeman P (2000) A positron emission tomography study of quetiapine in schizophrenia: a preliminary finding of an antipsychotic effect with only transiently high dopamine D2 receptor occupancy . Arch Gen Psychiatry57: 553–559
16.
Kapur S, Roy P, Daskalakis J, Remington G, Zipursky R (2001) Increased dopamine d(2) receptor occupancy and elevated prolactin level associated with addition of haloperidol to clozapine . Am J Psychiatry158: 311–314
17.
Lieberman J A, Saltz B L, Johns C A, Pollack S, Borenstein M, Kane J (1991) The effects of clozapine on tardive dyskinesia . Br J Psychiatry158: 503–510
18.
Llorca P M, Chereau I, Bayle F J, Lancon C (2002) Tardive dyskinesias and antipsychotics: a review . Eur Psychiatry17: 129–138
19.
Pilowsky L S, Mulligan R S, Acton P D, Ell P J, Costa D C, Kerwin R W (1997) Limbic selectivity of clozapine . Lancet350: 490–491
20.
Raja M, Azzoni A, Maisto G (1999) Three cases of improvement of tardive dyskinesia following olanzapine treatment . Int J Neuropsychopharmcol2: 333–334
21.
Richelson E, Souder T (2000) Binding of antipsychotic drugs to human brain receptors focus on newer generation compounds . Life Sci68: 29–39
22.
Seeman P (2002) Atypical antipsychotics: mechanism of action . Can J Psychiatry47: 27–38
23.
Simpson G M, Angus J W (1970) A rating scale for extrapyramidal side effects . Acta Psychiatr Scand212: 11–19
24.
Stephenson C M, Bigliani V, Jones H M, Mulligan R S, Acton P D, Visvikis D, Eu P J, Kerwin R W, Pilowsky L S (2000) Striatal and extra-striatal D(2)/D(3) dopamine receptor occupancy by quetiapine in vivo. [(123)I]epidepride single photon emission tomography (SPET) study . Br J Psychiatry177: 408–415
25.
Suzuki E, Obata M, Yoshida Y, Miyaoka H (2002) Tardive dyskinesia with risperidone and anticholinergics . Am J Psychiatry159: 1948
26.
Tollefson G D, Beasley C M Jr, Tamura R N, Tran P V, Potvin J H (1997) Blind, controlled, long-term study of the comparative incidence of treatment-emergent tardive dyskinesia with olanzapine or haloperidol . Am J Psychiatry154: 1248–1254
27.
Travis M J, Busatto G F, Pilowsky L S, Mulligan R, Acton P D, Gacinovic S, Mertens J, Terriere D, Costa D C, Eu P J, Kerwin R W (1998) 5-HT2A receptor blockade in patients with schizophrenia treated with risperidone or clozapine. A SPET study using the novel 5-HT2A ligand 123I-5-I-R-91150 . Br J Psychiatry173: 236–241
28.
Vesely C, Kufferle B, Brucke T, Kasper S (2000) Remission of severe tardive dyskinesia in a schizophrenic patient treated with the atypical antipsychotic substance quetiapine . Int Clin Psychopharmacol15: 57–60
29.
Waddington J L (1990) Spontaneous orofacial movements induced in rodents by very long-term neuroleptic drug administration: phenomenology, pathophysiology and putative relationship to tardive dyskinesia . Psychopharmacology (Berl)101: 431–447
