D3-Agonismus: Augmentierende Behandlungsmöglichkeit in der Tardiven Dyskinesie? Ein Fallbericht

Zusammenfassung

Anliegen Diese Kasuistik beschreibt einen Fall eines 21-jährigen Patienten mit schwerer, orofazialer, tardiver Dyskinesie (TD), welcher eine augmentative Behandlung mit Pramipexol (D3-Agonist) zur vorbestehenden polypharmazeutischen Therapie erhielt. Methode Es handelt sich um einen klinischen Behandlungsversuch. Ergebnisse Es kam zu einer relativen Besserung der orofazial betonten TD mit positivem Einfluss auf die Affektmodulation. Schlussfolgerung Pramipexol erwies sich als mögliche zusätzliche Behandlungsoption der TD.

Abstract

Objective Tardive dyskinesia (TD) is still a severe side effect induced by old neuroleptic drugs as well as modern atypical ones. The treatment is inefficient and often experimental. Aim of this study was to examine the effect of pramipexole, a dopamine D3 receptor agonist, in a severe case of oro-facial TD. Method The TD of a 21 year old male patient with severe oro-facial occurrence was assessed by the Simpson et al scale before starting pramipexole therapy. Reevaluation was made during therapy and when the maximum dose of 1.44 mg a day was reached. Standard therapy with clozapine, valproic acid, oxazepam, bornaprin hydrochlorid and tiapride was continued as before. Results Oral dyskinesia decreased 20 % and no side effects were observed. Regarding psychopathology the patient was more interested in work and showed better concentration in therapies. Conclusion Pramipexole could be a new promising add-on therapy in severe TD. Additionally, the low plasma binding and mild side effect profile of pramipexole makes it safe in combination with antipsychotic therapy.

Schlüsselwörter

Antipsychotika - Pramipexol - tardive Dyskinesie - D3-Agonist

Key words

tardive dyskinesia - D3 agonism - pramipexole

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