Reactions 437 - 6 Feb 1993

Clomipramine

Tardive dyskinesia-like syndrome: case reportAfter 1 week’s treatment with clomipramine 50 mg/day for

obsessive behaviour, a 51-year-old woman reported feelingsof restlessness and dry mouth. She was also receivingthiothixene, buspirone and trihexyphenidyl Two days later, shepresented with orobuccal movements, slurred speech anddysphagia. She also experienced repetitive arm movements,retracting movements of the abdomen and was unable to walkbecause of lower extremity restlessness and incoordination.She had previously experienced akathisia while receivingthioridazine. Clomipramine was withdrawn, and the doses ofthiothixene and buspirone reduced (buspirone was laterwithdrawn). Clonazepam 2 mg/day was initiated. Thewoman’s symptoms gradually improved and, 10 weeks later,no abnormal movements could be detected.

Author comment: Tricyclic antidepressants have beenassociated with several cases of a tardive dyskinesia-likesyndrome. Cases developing during clomipramine treatmenthave been reported to the manufacturer of clomipramine(Ciba-Geigy), often in association with haloperidol. Similarly,the syndrome in this patient cannot be entirely attributed toclomipramine as she was also taking thiothixene and had ahistory of antipsychotic-induced akathisiaGersten SP. Tardive dyskinesia-like syndromes with clomipramine. AmericanJournal of Psychiatry 150: 165-166, Jan 1993 - USA 800175531

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Reactions 6 Feb 1993 No. 4370114-9954/10/0437-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved