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Titolo:
TREATMENT OF SEVERE AXIAL TARDIVE DYSTONIA WITH CLOZAPINE - CASE-REPORT AND HYPOTHESIS
Autore:
TRUGMAN JM; LEADBETTER R; ZALIS ME; BURGDORF RO; WOOTEN GF;
Indirizzi:
UNIV VIRGINIA,HLTH SCI CTR,DEPT NEUROL,BOX 394 CHARLOTTESVILLE VA 22908 WESTERN STATE HOSP,DEPT PSYCHIAT MED STAUNTON VA 00000
Titolo Testata:
Movement disorders
fascicolo: 4, volume: 9, anno: 1994,
pagine: 441 - 446
SICI:
0885-3185(1994)9:4<441:TOSATD>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
D2 DOPAMINE-RECEPTORS; STRIATOPALLIDAL NEURONS; D1; DYSKINESIA; EXPRESSION; RATS; STIMULATION; RESPONSES; OCCUPANCY; INVIVO;
Keywords:
CLOZAPINE; TARDIVE DYSTONIA; DYSKINESIA; D1/D2 DOPAMINE RECEPTOR;
Tipo documento:
Note
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
36
Recensione:
Indirizzi per estratti:
Citazione:
J.M. Trugman et al., "TREATMENT OF SEVERE AXIAL TARDIVE DYSTONIA WITH CLOZAPINE - CASE-REPORT AND HYPOTHESIS", Movement disorders, 9(4), 1994, pp. 441-446

Abstract

We report a patient with severe axial tardive dystonia who has had dramatic improvement for 4 years after treatment with the atypical antipsychotic drug clozapine (625 mg/day). Clozapine differs from conventional neuroleptics in that it has higher affinity for D1 and lower affinity for D2 dopamine receptors than do conventional antipsychotics, which are relatively selective D2 antagonists. We propose that repetitivestimulation of the D1 receptor by endogenous dopamine, resulting in sensitization of the D1-mediated striatal output in the presence of D2 receptor blockade, is a fundamental mechanism mediating tardive dyskinesia, including the dystonic type. According to this hypothesis, it isprimarily the D1 antagonist action of clozapine that accounts for itsinability to cause tardive dyskinesia as well as its therapeutic effect in tardive dystonia. Regardless of its mechanism of action, the sustained improvement observed in this case suggests that clozapine should be tried in cases of severe refractory tardive dystonia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 15:14:17