Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-23T06:52:51.366Z Has data issue: false hasContentIssue false

De novo Tardive Tourette‐like syndrome after prolonged combination depot and oral neuroleptic therapy

Published online by Cambridge University Press:  21 February 2013

Jegan Yogaratnam
Affiliation:
Woodbridge Hospital/Institute of Mental Health, Singapore, Singapore
Changqing Xu
Affiliation:
Woodbridge Hospital/Institute of Mental Health, Singapore, Singapore
Daw San San Thinn
Affiliation:
Woodbridge Hospital/Institute of Mental Health, Singapore, Singapore
Lee Kim Yoong
Affiliation:
Woodbridge Hospital/Institute of Mental Health, Singapore, Singapore
Chai Ling Khoo
Affiliation:
Woodbridge Hospital/Institute of Mental Health, Singapore, Singapore
Kang Sim*
Affiliation:
Woodbridge Hospital/Institute of Mental Health, Singapore, Singapore
*
Associate Professor Kang Sim, Woodbridge Hospital/Institute of Mental Health, 10 Buangkok View, Singapore 539747, Singapore. Tel: (65) 63892000 Fax: (65) 63855900 E‐mail: [email protected]

Abstract

Introduction

Tardive Tourette‐like syndrome is recognised by the observation of several motor and vocal tics often in individuals receiving psychotropic medications and can happen within 1–3 months of treatment.

Clinical case

We report a case which is unique in its onset of Tardive Tourette‐like syndrome comprising of vocal, motor tics and coprolalia after more than three decades of treatment with combination depot and oral neuroleptics.

Discussion

Use of the Naranjo Adverse Drug Reaction Probability Scale indicates a probable relationship between the onset of Tardive Tourettism and the antipsychotic therapy in this patient. This was in contrast to earlier reports which noted earlier onset and partial reversal with termination or change of medications. Clinicians need to pay heed to the emergence of late‐onset Tourettism in order to better manage its manifestation and prevent its worsening in the context of holistic care for patients with neuropsychiatric conditions including schizophrenia.

Type
Case Report
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Golden, GS. Gilles de la tourette's syndrome following methylphenidate administration. Dev Med Child Neurol 1974;16:7678.Google Scholar
2Klempel, K. Gilles de la tourette's symptoms induced by L‐dopa. S Afr Med J 1974;48:13791380.Google Scholar
3Perry, R, Nobler, MS, Campbell, M. Tourette‐like symptoms associated with neuroleptic therapy in an autistic child. J Am Acad Child Adolesc Psychiatry 1989;28:9396.Google Scholar
4Seemuller, F, Dehning, S, Grunze, H et al. Tourette's symptoms provoked by lamotrigine in a bipolar patient. Am J Psychiatry 2006;163:159.Google Scholar
5Gillman, MA, Sandyk, R. Clonazepam‐induced Tourette syndrome in a subject with hyperexplexia. Postgrad Med J 1987;63:311312.CrossRefGoogle Scholar
6Lombroso, CT. Lamotrigine‐induced tourettism. Neurology 1999;52:11911194.Google Scholar
7Neglia, JP, Glaze, DG, Zion, TE. Tics and vocalizations in children treated with carbamazepine. Pediatrics 1984;73:841844.Google Scholar
8Klawans, HL, Falk, DK, Nausieda, PA et al. Gilles de la Tourette syndrome after long‐term chlorpromazine therapy. Neurology 1978;28:10641066.CrossRefGoogle ScholarPubMed
9Jaffe, E, Tremeau, F, Sharif, Z et al. Clozapine in tardive Tourette syndrome. Biol Psychiatry 1995;38:196197.Google Scholar
10Willmund, G, Lee, AH, Wertenauer, F et al. Vocal tics associated with ziprasidone. J Clin Psychopharmacol 2009;29:611612.Google Scholar
11Fountoulakis, KN, Panagiotidis, P. Tardive Tourette-like syndrome in a patient treated with paliperidone. J Neuropsychiatry Clin Neurosci 2011;23:E3536.CrossRefGoogle Scholar
12Fennig, S, Fennig, SN, Pato, M et al. Emergence of symptoms of tourette's syndrome during fluvoxamine treatment of obsessive–compulsive disorder. Br J Psychiatry 1994;164:839841.Google Scholar
13Naranjo, CA, Busto, U, Sellers, EM et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30:239245.CrossRefGoogle ScholarPubMed
14Lal, S, AlAnsari, E. Tourette‐like syndrome following low dose short‐term neuroleptic treatment. Can J Neurol Sci 1986;13:125128.Google Scholar
15Kozian, R, Friederich, M. Gilles‐de‐la‐tourette syndrome as a tardive dyskinesia. Psychiatr Prax 2007;34:253254.Google Scholar
16Seeman, MV, Patel, J, Pyke, J. Tardive dyskinesia with Tourette‐like syndrome. J Clin Psychiatry 1981;42:357358.Google Scholar
17Stahl, SM. Tardive tourette syndrome in an autistic patient after long‐term neuroleptic administration. Am J Psychiatry 1980;137:12671269.Google Scholar
18Minzer, K, Lee, O, Hong, JJ et al. Increased prefrontal D2 protein in tourette syndrome: a postmortem analysis of frontal cortex and striatum. J Neurol Sci 2004;219:5561.Google Scholar
19Muller, N, Riedel, M, Zawta, P et al. Comorbidity of tourette's syndrome and schizophrenia–biological and physiological parallels. Prog Neuropsychopharmacol Biol Psychiatry 2002;26:12451252.Google Scholar
20Reid, SD. Neuroleptic‐induced Tardive Tourette treated with clonazepam: a case report and literature review. Clin Neuropharmacol 2004;27:101104.CrossRefGoogle ScholarPubMed