Oculogyric crisis with exacerbation of psychosis: Possible mechanism and clinical implications

Oculogyric crisis is a distressing acute/chronic side effect of neuroleptic medications. Chronic oculogyric crisis can be considered as a tardive hyperkinetic movement disorder and it may be associated with worsening of psychotic symptoms. Treatment strategies for chronic oculogyric crisis include; high potency antipsychotics and anticholinergics drugs for immediate relief and clozapine as a long-term treatment strategy. Here we are presenting case histories of four patients with oculogyric crisis and associated worsening of psychosis, its possible etiology and various treatment strategies.