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Androgen insensitivity and liability to drug-induced extrapyramidal symptoms

Panagiotis Ferentinos1, Emmanouil Rizos, Athanassios Douzenis

  • 1Second Department of Psychiatry, Athens University Medical School, Attikon General Hospital, Athens, Greece. pferentinos@med.uoa.gr

Gender Medicine
|April 8, 2011
PubMed
Abstract

Insights

Patients with androgen insensitivity syndrome (AIS) may be more prone to drug-induced extrapyramidal symptoms (EPS). Careful selection of antipsychotics is recommended for psychosis treatment in AIS patients.

Area of Science:

  • Endocrinology
  • Neuroscience
  • Genetics

Background:

  • Androgen insensitivity syndrome (AIS) is a disorder of sex development in 46,XY individuals.
  • Caused by androgen receptor gene mutations, leading to partial or complete androgen resistance.

Observation:

  • A 28-year-old patient with partial AIS developed severe extrapyramidal symptoms (EPS) after starting risperidone.
  • The patient had a history of paranoid ideation and discontinued estrogen therapy.

Findings:

  • The patient responded well to sertindole with no motor side effects after switching from risperidone.
  • This suggests a potential increased susceptibility to drug-induced EPS in AIS patients.

Implications:

  • AIS patients may have heightened risk for drug-induced EPS due to potential striatal dysfunction or direct effects on nigrostriatal pathways.
  • Clinicians should exercise caution when treating psychosis in AIS patients, favoring antipsychotics with lower EPS risk.

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