Oculogyric Crisis with Clozapine: A Case Report and Review of Similar Case Reports in the Literature

Nebhinani, Naresh; Modi, Manish

doi:10.4103/0253-7176.162946

Cited by 9 publications

(6 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Acute dystonic reactions are commonly seen with the use of high-potency typical antipsychotics, relatively uncommon with atypical antipsychotics, 36 and rarely reported with clozapine. 37 A few cases of acute dystonic reaction, including OGC, have been associated with anesthetic agents like propofol, sevoflurane, nitrous oxide, and fentanyl administration. 38 …”

Section: Resultsmentioning

confidence: 99%

“… 43 But rarely, in some cases, OGC has been reported with the use of clozapine. 37 Electro-convulsive therapy can also be given in tardive OGC cases with psychotic disorders. 55 …”

Section: Resultsmentioning

confidence: 99%

“…Acute dystonic reactions are commonly seen with the use of high-potency typical antipsy-chotics, relatively uncommon with atypical antipsychotics, 36 and rarely reported with clozapine. 37 A few cases of acute dystonic reaction, including OGC, have been associated with anesthetic agents like propofol, sevoflurane, nitrous oxide, and fentanyl administration. 38 In recent times, most of the literature is associated with varied causes of OGC belonging to either neurometabolic disorders such as AADC deficiency, sepiapterin reductase deficiency, TUBB4A-related leukodystrophy 39 or medications (apart from what mentioned in Table 1) like anti-tubercular drugs, 40 or clebopride, a non-selective benzamide with antidopaminergic activity.…”

Section: Etiology Of Ogcmentioning

confidence: 99%

“…43 But rarely, in some cases, OGC has been reported with the use of clozapine. 37 Electro-convulsive therapy can also be given in tardive OGC cases with psychotic disorders. 55 Prophylactic use of anticholinergic drugs for 1-2 weeks is indicated in patients with greater vulnerability for OGC with certain antipsychotics, though the available guidelines are inconsistent for the duration of use of such prophylactic agents.…”

Section: Mechanism Of Ogcmentioning

confidence: 99%

See 3 more Smart Citations

Spotlight on Oculogyric Crisis: A Review

Mahal

Suthar

Nebhinani

2020

Indian Journal of Psychological Medicine

Self Cite

View full text Add to dashboard Cite

Background: Oculogyric crisis (OGC) is a form of acute dystonia characterized by sustained dystonic, conjugate, and upward deviation of the eyes. It was initially reported in patients with postencephalitic parkinsonism. But later, other factors such as medications, movement disorders, metabolic disorders, and focal brain lesions were also found to be associated with OGC. Methods: The literature regarding OGC was searched via PubMed, Google Scholar, and through citations in relevant articles till December 2019, with keywords including OGC, oculogyric eye movements, tonic eye movement, neuroleptics and OGC, antipsychotics and OGC, and all combinations of these. Only original articles (abstract or full text) that were published in the English language were reviewed. Results: Hypodopaminergic state is implicated in the pathogenesis of OGC. Common risk factors are younger age, male sex, severe illness, high neuroleptic dose, parenteral administration of neuroleptics, high potency of neuroleptic drugs, abrupt discontinuation of anticholinergic medication, and family history of dystonia. Conclusion: OGC is an acute dystonic reaction leading to tonic upward deviation of eyes. It is associated with various neurometabolic, neurodegenerative, and movement disorders and medications such as antipsychotics, antiemetics, antidepressants, antiepileptics, and antimalarials. OGC can adversely impact the compliance and prognosis of the primary illness. Hence, it needs to be managed at earlier stages with appropriate medication, primarily anticholinergics.

show abstract

Section: Resultsmentioning

confidence: 99%

“… 43 But rarely, in some cases, OGC has been reported with the use of clozapine. 37 Electro-convulsive therapy can also be given in tardive OGC cases with psychotic disorders. 55 …”

Section: Resultsmentioning

confidence: 99%

Section: Etiology Of Ogcmentioning

confidence: 99%

Section: Mechanism Of Ogcmentioning

confidence: 99%

See 2 more Smart Citations

Spotlight on Oculogyric Crisis: A Review

Mahal

Suthar

Nebhinani

2020

Indian Journal of Psychological Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…In cases of tardive OGCs the aforementioned agents might be insufficient and long-term treatment with (atypical) neuroleptics such as clozapine might be required [124,125]. However, it should be noted that treatment effects might be limited in tardive OGCs, as substances such as clozapine themselves may also cause OGCs [126][127][128].…”

Section: Treatmentmentioning

confidence: 99%

Oculogyric crises: Etiology, pathophysiology and therapeutic approaches

Barow

Schneider

Bhatia

et al. 2017

Parkinsonism & Related Disorders

View full text Add to dashboard Cite

Oculogyric crisis (OGC) describes the clinical phenomenon of sustained dystonic, conjugate and typically upward deviation of the eyes lasting from seconds to hours. It was initially observed in patients with postencephalitic parkinsonism, but since then a number of conditions have been associated with OGC. These include drug-induced reactions, hereditary and sporadic movement disorders, and focal brain lesions. Here, we systematically review the literature and discuss the spectrum of disorders associated with OGC in order to aid clinicians place this rare but distinctive clinical sign into the appropriate diagnostic context. We also provide a brief synthesis of putative pathophysiological mechanisms, as well as therapeutic recommendations based on the literature and our own experience.

show abstract

Antipsychotic Drugs

Chue

2016

Side Effects of Drugs Annual

View full text Add to dashboard Cite

Oculogyric Crisis with Clozapine: A Case Report and Review of Similar Case Reports in the Literature

Abstract: Oculogyric crisis (OGC) is a dystonic reaction and commonly caused by typical antipsychotics and rarely occurs with clozapine. Here, we are presenting a case of OGC with clozapine therapy and reviewing the similar cases reported in the literature.

Cited by 9 publications

References 6 publications

Spotlight on Oculogyric Crisis: A Review

Spotlight on Oculogyric Crisis: A Review

Oculogyric crises: Etiology, pathophysiology and therapeutic approaches

Antipsychotic Drugs

Contact Info

Product

Resources

About