Tardive Oculogyric Crisis Associated With Quetiapine Use

Ghosh, Soumitra; Bhuyan, Dhrubajyoti; Bhattacharya, Aniruddha; Roy, Debjit; Saddichha, Sahoo

doi:10.1097/jcp.0b013e3182878b2e

Cited by 18 publications

(10 citation statements)

References 5 publications

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“…These movements most likely represented ocular dyskinesias, given that all patients described had choreiform dyskinesias, and all movements responded well to TBZ . With these caveats, cases of tardive OGC have been described with typical antipsychotics including fluphenazine and atypical antipsychotics including olanzapine and quetiapine (both of which responded to anticholinergics, suggesting a delayed ADR rather than a tardive dyskinesia variant), amisulpride after 18 weeks of therapy with resolution upon substitution with clozapine, and clozapine after 1 to 2 years . In some cases, the OGC persisted after withdrawal of the offending medication, behaving more like a tardive disorder than an ADR.…”

Section: Causes Of Ogcmentioning

confidence: 99%

Oculogyric crises: A review of phenomenology, etiology, pathogenesis, and treatment

Slow

Lang

2017

Mov Disord.

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Oculogyric crises are a rare movement disorder characterized by paroxysmal, conjugate, tonic, usually upwards, deviation of the eyes. Causes for oculogyric crises are limited and include complications of dopamine-receptor blocking medications and neurometabolic disorders affecting dopamine metabolism, suggesting that an underlying hypodopaminergic state is important to the pathogenesis. Mimickers of oculogyric crises exist, and we propose diagnostic criteria to distinguish true oculogyric crises. Recognition of oculogyric crises is important for the diagnosis and appropriate treatment of rare disorders, and an approach to investigations in oculogyric crises is proposed. © 2017 International Parkinson and Movement Disorder Society.

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Section: Causes Of Ogcmentioning

confidence: 99%

Oculogyric crises: A review of phenomenology, etiology, pathogenesis, and treatment

Slow

Lang

2017

Mov Disord.

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“…OGC associated with quetiapine is rarely reported,[ 5 ] due to its intermediate D2 receptor affinity and fast dissociation action. [ 12 ] Olanzapine in higher doses shows a higher D2 binding affinity,[ 13 ] which probably increases the risk of OGC.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 ] Acute dystonic reactions are seen commonly seen in young age, male gender, with use of high-potency typical antipsychotics, high dose, and parenteral drug administration. [ 2 ] OGC is rarely reported with atypical antipsychotics such as olanzapine,[ 3 4 ] quetiapine,[ 5 ] aripiprazole,[ 6 7 ] and amisulpride. [ 8 ] Here, we report presentation and management of five cases of oculogyric crisis caused by different atypical antipsychotic agents.…”

Section: Introductionmentioning

confidence: 99%

Oculogyric crisis with atypical antipsychotics: A case series

Nebhinani¹,

Suthar²

2017

Indian J Psychiatry

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Oculogyric crisis (OGC) is an acute dystonic reaction, commonly seen with the administration of typical antipsychotics, and rarely reported with atypical antipsychotics. Here, we report five cases of oculogyric crisis, developed after administration of atypical antipsychotics. The first case developed OGC on quetiapine 800 mg/day and the second case on olanzapine 20 mg/day. Both the patients did not improve on adding anticholinergic agents and finally stabilized by switching to clozapine. The third case developed OGC on amisulpride 400 mg and lurasidone 40 mg/day and improved by reducing amisulpride dose to 200 mg and stopping lurasidone. The fourth case developed OGC on aripiprazole 30 mg/day and improved by dose reduction. The fifth case developed OGC on amisulpride 400 mg/day and improved by switching to risperidone and anticholinergic combination. Oculogyric crisis is a potential side effect of antipsychotic medications (mostly with typical and rarely with atypical) and generally respond to oral anticholinergics, but in some cases, dose reduction or discontinuation of antipsychotic agent and switching to safer alternatives or clozapine is required.

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“…Product monographs indicate that OGC is a possible adverse dyskinetic effect with all second-generation antipsychotics. Cases of acute-and tardive-onset OGC have been reported with olanzapine, [8][9][10][11][12] quetiapine, 13 clozapine, [14][15][16][17] risperidone, [18][19][20] aripiprazole, 21-23 and ziprasidone. [24][25][26] Here, we estimate the incidence rate of OGC in an early intervention service for psychosis and provide details regarding the antipsychotics implicated, clinical presentation, and long-term outcomes of OGC.…”

mentioning

confidence: 99%

Incidence of Oculogyric Crisis and Long-Term Outcomes With Second-Generation Antipsychotics in a First-Episode Psychosis Program

Gardner

Abidi

Ursuliak³

et al. 2015

Journal of Clinical Psychopharmacology

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Oculogyric crisis (OGC) is an often recurrent dystonic adverse effect of antipsychotic treatment characterized by a sustained fixed upward gaze lasting minutes to hours. The risk of OGC has not been established. We prospectively estimated the incidence rate of OGC in an early intervention service for psychosis and provided details regarding the antipsychotics implicated, clinical presentation, and long-term outcomes of OGC. The Nova Scotia Early Psychosis Program provides comprehensive, team-based care to youth and young adults with schizophrenia spectrum disorder. For 6 years (April 2008 to March 2014), 452 new patients were admitted to the program and participated in an individualized program of care. Eight patients (4 females; mean age, 19.8 years) developed recurrent episodes of OGC after 3 months to 2 years of treatment with 1 or more second-generation antipsychotics, yielding an incidence rate of 1.8% (95% confidence interval, 0.9%-3.4%). Risperidone or olanzapine (alone or in combination with a second antipsychotic) seemed causative in each case. Also implicated in the onset or recurrence of oculogyric episodes were ziprasidone, quetiapine, clozapine, aripiprazole, and the first-generation antipsychotic loxapine. Follow-up ranged between 2 and 7 years. Episodes stopped after switching antipsychotic treatment in 4 cases and after stopping antipsychotic treatment in 2 cases. In the other 2 cases, recurrences were ongoing at last follow-up 2 and 6 years after onset with antipsychotic treatment continuing. We observed a high rate of tardive-onset, recurrent, and potentially chronic ocular dystonias in patients with first-episode psychosis caused by the use of second-generation antipsychotics.

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Tardive Oculogyric Crisis Associated With Quetiapine Use

Cited by 18 publications

References 5 publications

Oculogyric crises: A review of phenomenology, etiology, pathogenesis, and treatment

Oculogyric crises: A review of phenomenology, etiology, pathogenesis, and treatment

Oculogyric crisis with atypical antipsychotics: A case series

Incidence of Oculogyric Crisis and Long-Term Outcomes With Second-Generation Antipsychotics in a First-Episode Psychosis Program

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