Successful Treatment of Tardive Diaphragmatic Flutter in an Elderly Man with Aripiprazole

Abstract

Tardive dyskinesia (TD) is a severe adverse effect induced by prolonged treatment with antipsychotics. The development of TD is usually associated with advanced age, female sex, prior extrapyramidal adverse effects, and a longer duration or an intermittent course of antipsychotic treatment. Older age, however, is the most robust risk factor for TD. Tardive diaphragmatic flutter is an uncommon form of TD and may lead to great distress in the patient's life. No effective treatment advice for tardive diaphragmatic flutter has been suggested. We herein report the case of a 65-year-old male with bipolar disorder who suffered from tardive diaphragmatic flutter associated with the long-term usage of risperidone. The diaphragmatic flutter remitted for 2 years under the monotherapy with aripiprazole. Potential mechanisms, such as the dopamine stabilization in aripiprazole, are discussed.

Keywords

• aripiprazole
• clozapine
• elderly
• tardive diaphragmatic flutter
• tardive dyskinesia