Primary research

Treatment of severe neuroleptic-induced tardive torticollis

Beata J Havaki-Kontaxaki , Vassilis P Kontaxakis , Maria M Margariti , Konstantinos G Paplos and George N Christodoulou

Department of Psychiatry, University of Athens, Eginition Hospital, Athens, Greece

author email corresponding author email

Annals of General Hospital Psychiatry 2003, 2:9doi:10.1186/1475-2832-2-9

Published:	17 October 2003

Abstract

Background

The aim of this paper is to describe a case of severe neuroleptic-induced tardive torticollis successfully treated with a combination of clozapine, clonazepam and botulinum toxin-A.

Case Report

The patient, a 30-year old man with a seven-year history of delusional disorder experienced severe right torticollis with painful tightness of the neck and elevation of the shoulder. At this time he was receiving haloperidol 20 mg, trifluoperazine 5 mg, zuclopenthixol 20 mg and biperidine 4 mg daily. The combination therapy with clozapine and clonazepam and the long-term use of botulinum toxin-A resulted in a complete remission of dystonic movements.

Conclusions

The present observations provide evidence indicating that this combination therapy may be of benefit in patients with severe neuroleptic-induced tardive torticollis.