Aripiprazole (abilify) and tardive dyskinesia

Area of Science:

• Psychiatry
• Pharmacology
• Neurology

Background:

• Second-generation antipsychotics (SGAs) are widely prescribed for their favorable side effect profiles regarding extrapyramidal symptoms (EPS) and tardive dyskinesia (TD).
• Metabolic adverse effects have become a significant focus in clinical practice and research concerning SGAs.
• Off-label use of SGAs is common, expanding their application beyond approved indications.

Observation:

• A case report details a patient who developed tardive dyskinesia (TD).
• The patient was treated with aripiprazole, an atypical antipsychotic, as an off-label augmentation strategy.
• The indication for aripiprazole was treatment-resistant depression.

Findings:

• Aripiprazole, despite its lower risk of EPS/TD compared to older antipsychotics, can still induce tardive dyskinesia.
• This case demonstrates that TD remains a potential adverse effect even with newer antipsychotic agents.
• The development of TD occurred in the context of off-label use for treatment-resistant depression.

Implications:

• Clinicians must remain vigilant for tardive dyskinesia (TD) in patients using second-generation antipsychotics, including off-label.
• Despite the focus on metabolic risks, the potential for neurological side effects like TD persists.
• Ongoing monitoring for TD is crucial for all patients treated with atypical antipsychotics, regardless of indication.