Oculogyric Crises

Solberg, Marianne; Koht, Jeanette

doi:10.7916/d85x2n2d

Cited by 2 publications

(2 citation statements)

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“…It is associated with several potential adverse effects, including metabolic side effects such as weight gain and dyslipidemia as well as Parkinsonism, tardive dyskinesia, akathisia, neuroleptic malignant syndrome, and acute dystonia such as oculogyric crisis [ 1 , 2 ]. Treatment of adverse effects associated with aripiprazole involves adjusting the antipsychotic dosage [ 3 ] as well as medication intervention to target the specific adverse effect: a beta blocker for akathisia [ 2 ], a VMAT2 inhibitor such as tetrabenazine for tardive dyskinesia [ 4 ], and benztropine or diphenhydramine for acute dystonia [ 5 , 6 ]. Oculogyric crisis (OGC) is an acute dystonic reaction characterized by sustained, bilateral, and upward deviation of the eyes [ 3 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Treatment of adverse effects associated with aripiprazole involves adjusting the antipsychotic dosage [ 3 ] as well as medication intervention to target the specific adverse effect: a beta blocker for akathisia [ 2 ], a VMAT2 inhibitor such as tetrabenazine for tardive dyskinesia [ 4 ], and benztropine or diphenhydramine for acute dystonia [ 5 , 6 ]. Oculogyric crisis (OGC) is an acute dystonic reaction characterized by sustained, bilateral, and upward deviation of the eyes [ 3 , 6 ]. Episodes can last seconds to hours [ 6 , 7 ], and it is often preceded by anxiety or emotional lability [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Oculogyric Crisis after Initiation of Aripiprazole: A Case Report of an Active Duty Service Member

Hadler

Roh

Nissan

2023

Case Reports in Psychiatry

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Introduction. Oculogyric crisis is an acute dystonic reaction characterized by sustained, bilateral, and upward deviation of the eyes. It is a relatively uncommon extrapyramidal side effect of antipsychotic medications. Aripiprazole is an atypical antipsychotic that is FDA-approved for the treatment of schizophrenia, bipolar disorder, Tourette’s disorder, and treatment resistant major depressive disorder. Compared to other antipsychotics, it is thought to have a lower propensity for causing dystonic side effects. Clinical Case. This case report is of a 19-year-old male who was psychiatrically hospitalized for first episode psychosis and initiated on low-dose oral aripiprazole. Three days after initiation of the medication, the patient was found to be markedly anxious and pacing around his room. Exam was notable for intermittent upward eye rolling, sustained upward conjugate gaze, and limited downward gaze. No other facial dyskinetic movements were observed. Treatment. The patient’s oral aripiprazole was held, and he was administered 50 mg of oral diphenhydramine with improvement in symptoms within one hour. Ocular symptoms, dizziness, frontal headache, and pacing were resolved the following morning. He declined reinitiation of an antipsychotic medication. Conclusion. Aripiprazole-induced acute dystonia, specifically OGC, is a rare potential adverse effect of aripiprazole. Risk factors include male gender, young age, use of typical antipsychotics, and initiation or uptitration of an antipsychotic. Even though atypical antipsychotics including aripiprazole are associated with lower risk for extrapyramidal symptoms, the possibility of oculogyric dystonia merits close monitoring especially in young, male, and drug naive patients. Anticholinergic agents such as diphenhydramine can treat symptoms of acute dystonia.

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