Ziprasidone-related oculogyric crisis in an adult.

INTRODUCTION

Drug-induced dyskinesias are common side-effects of first-generation antipsychotics (FGAs) but are not usually related to second-generation antipsychotics (SGAs). Oculogyric crisis (OGC) is a disabling acute dystonia that affects extra-ocular muscles usually resulting in an upward deviation of the eyes, which lasts from minutes to hours.

CASE REPORT: We describe an adult patient, previously exposed to an FGA, who developed OGC on 80mg/day of ziprasidone. The movement disorder significantly improved after use of 1mg/day of clonazepam without the need to switch to another SGA.

DISCUSSION: The clinical features of the movement disorder of our patient meet the criteria for OGC. It is, sometimes, difficult to directly correlate a drug-induced dyskinesia to a SGA due to previous exposures to FGAs. The onset of OGC after exposure to ziprasidone without simultaneous use of other antipsychotic suggests a casual relationship between the former and the movement disorder. It is possible that previous use of an FGA was a risk factor for the development of OGC.

CONCLUSION

To the best of our knowledge, this is the first report of ziprasidone-related OGC in an adult patient. Physicians must be aware of its occurrence in order to improve care of patients treated with these agents.