| Abstract [eng] |
Introduction. Tardive dyskinesia is a movement disorder that starts after a few months of dopamine receptor-blocking agents exposure and can continue even if the drug causing the reaction was discontinued. Dopamine receptor-blocking agents are widely used in the treatment of various mental ilnesses, making tardive dyskinesia an integral part of psychiatry. Case description. A 62 – year-old man diagnosed with paranoid schizophrenia. During the first hospitalization, after treatment with haloperidol, the patient developed acute dystonia. Therefore, the treatment was adjusted, a second-generation antipsychotic was prescribed – risperidone, which the patient took for 7 years. Under the influence of this drug, strong symptoms of tardive dyskinesia started, which had a very negative impact on patient‘s quality of life. The patient‘s treatment was adjusted again, olanzapine and trihexyphenidyl were prescribed but the condition did not improve. Treatment with tetrabenazine was recommended, the patient‘s condition improved, but due to the high price of the drug, the patient did not buy it. When the patient‘s condition deteriorated, he attempted suicide, because he was no longer able to work, experienced financial difficulties – he began to feel anxiety and stress about his condition. Over the years, the patient‘s work capacity decreases even more, and since 2024 it is documented that the patient has lost the ability to take care of himself. Literature review. The main difficulty in the treatment of tardive dyskinesia is that it is often necessary to continue treatment with antipsychotic drugs due to the mental state of the patients. According to the American Academy of Neurology (AAN) guidelines, it is recommended to start treatment with second-generation antipsychotics. The first-line drugs of tardive dyskinesia are deutetrabenazine and valbenazine. If these drugs are not available, then tetrabenazine is recommended. Currently, only tetrabenazine is registered in Lithuania. Conclusions. Although the number of research on the pathophysiology and treatment options of tardive dyskinesia is increasing, it is still insufficient. Therefore, more studies with larger samples and uniform conditions should be conducted. |
