Relapse of Tardive Dyskinesia and Recovery from a Granulocytosis due to reduction in Clozapine dose

摘要

Clozapine is a second generation atypical antipsychotic agent, which has been established efficient against resistant positive and negative symptoms of schizophrenia with low propensity to induce tardive dyskinesia (TD). Clozapine has a greater affinity to dopamine D_4 than D_2 receptors with additional action on serotonin more specially 5-HT_(2A) receptors. Clozapine produces few extrapyromidal side effects and TD is rare due its less affinity for D_2 receptors in nigrostriatal dopaminergic pathways. TD is one of the muscular side effects of antipsychotic drugs. TD is primarily characterized by abnormal involuntary movements of the tongue, lips, jaws as well as extermitis that develop in association with the use of antipsychotic medication. TD can be embarrassing to the affected patient in public. The movements disappear automatically disappear during sleep and women are at greater risk. Agronubocytosis induced by clozapine may be life threatening in many patients but it is not dose dependent.