NERMİN GÜNDÜZ, Hatice TURAN, Tülay Satı KIRKAN

Düşük doz olanzapin kullanımı sonrası gelişen tortikollis ve tedavisi: Bir olgu sunumu

Olanzapin, mezolimbik dopaminerjik yolağı nigrostriatal dopamin yolağından daha fazla etkileyen ve bu nedenle daha az ekstrapiramidal belirtilere neden olan, psikotik bozuklukların ve duygudurum bozukluklarının tedavisinde kullanılan bir atipik antipsikotiktir. Tardive distoni ise atipik antipsikotik kullanımı sonrasında nadir görülen, sürekli kas kasılması ile giden, ağrılı, kıvrılma hareketleri ile karakterize bir durumdur. Tardive distonide etkin tedavi seçenekleri sınırlıdır. Ayırıcı tanıda akut distoni, nörolojik hastalıklar ve aile öyküsü dışlanmalıdır. Bu yazıda, başka türlü adlandırılamayan psikotik bozukluk tanısıyla, olanzapin 5 mg/gün kullanan, genç kadın hastada gelişen tortikollis tablosu ve tedavisi tartışılmıştır. (Anadolu Psikiyatri Derg 2016; 17(Ek.3):8-10).

Low dose olanzapine induced torticollis and treatment: a case report

Olanzapine is a second generation antipsychiotic agent that is used for the treatment of the psychotic disorders and mood disorders. Olanzapine is also known to have greater affinity for mezolimbic dopaminergic pathway than for nigrostriatal dopamine pathway. As a result olanzapine is associated with significantly fewer extrapyramidal symptoms. Tardive dystonia is a rare side effect of antipsychotic treatment frequently causing twisting painfull muscle contractions. Effective treatment choice for tardive dystonia is limited. The clinicans must consider acute dystonia neurological disorders and family history for differential diagnosis. Here we present a rare case of torticollis after 5 mg/day olanzapine treatment in a young female patient with psychotic disorder. (Anatolian Journal of Psychiatry 2016; 17(Suppl.3):8-10).

___

1. Van Harten PN, Kahn RS. Tardive dystonia. Schizophrenia Bull 1999; 25:741-748.

2. Kiriakakis V, Bhatia KP, Quinn NP, Marsden CD. The natural history of tardive dystonia. A long-term follow-up study of 107 cases. Brain. 1998; 121(11):2053-2066.

3. Adityanjee MD, Adezibijde YA, Jampala C, Mathews T. The currentstatus of tardive dystonia. Biol Psychiatry 1999; 45:715-730.

4. Keegan DL, Rajput AH. Drug induced dystonia tarda: treatment with L-dopa. Dis Nerv Syst 1973; 34(3):167- 169.

5. Burke RE, Fahn S, Jankovic J, Marsden CD, Lang AE, Gollomp S, et al. Tardive dystonia: Late onset and persistent dystonia caused by antipsychotic drugs. Neurology 1982; 32:1335-46.

6. Kang UJ, Burke RE, Fahn S. Tardive dystonia. Fahn S (ed.), Advances in Neurology Dystonia second ed., New York: Raven Press, 1988, p.415-429.

7. Friedman JH, Kucharski LT, Wagner RL. Tardive dystonia in a psychiatric hospital. J Neurol Neurosurg Psychiatry 1987; 50:801-803.

8. Gimenez-Roldan S, Mateo D, Bartolome P. Tardive dystonia and severe tardive dyskinesia: a comparison of risk factors and prognosis. Acta Psychiatr Scand 1985; 71:488-494.

9. Bhana N, Foster RH, Onley R, Plosker GL. Olanzapine: An updated review. Drugs 2001; 61:111-161.

10. Trugman JM, Leadbetter R, Zalis ME, Burgdorf RO, Wooten GF. Treatment of severe axial tardive dystonia with clozapine: case report and hypothesis. Mov Disord 1994; 9(4):321-324.

11. Aggarwal A, Jiloha RC. Olanzapine induced tardive dystonia. Indian J Pharmacol 2008; 40(5):237-238.

12. Gunal DI, Onultan O, Afsar N, Aktan S. Tardive dystonia associated with olanzapine therapy. Neurol Sci 2001; 22:331-332.

13. Dunayevich E, Strakowski SM. Olanzapine induced tardive dystonia. Am J Psychiatry 1999; 156:1662.

14. Sun Z, Wang X. Case report of refractory tardive dystonia induced by olanzapine. Shanghai Archives of Psychiatry 2014; 26(1):51-53.

15. Gourzis P, Polychronopoulos P, Papapetropoulos S, Assimakopoulos K, Argyriou AA, Beratis S. Quetiapine in the treatment of focal tardive dystonia induced by other atypical antipsychotics a report of 2 cases. Clin Neuropharmacol 2005; 28:195-196.