Benefical Effects of Sigma-1 Agonist Fluvoxamine for Tardive Dyskinesia and Tardive Akathisia in Patients with Schizophrenia: Report of Three Cases
Ms M, a 36-year-old woman, had been diagnosed with schizophrenia for 6 years. She had been treated with quetiapine 600 mg/day for 5 years. For the last 1 year, she has been treated with olanzapine 20 mg/day. She began complaining of severe motor restlessness and an unbearable state of never being able to sit still for one month before her last visit for regular outpatient clinic control. The results of brain MRI, EEG, blood chemistry, a complete blood count, and thyroid function tests were all normal. On psychiatric and physical examination, anxiety, agitation and akathisia were noted. Ms M was diagnosed with schizophrenia, residual type; and medication induced movement disorder (tardive akathisia) according to the DSMIV-TR. On the Barnes Akathisia Rating Scale (BARS), global score was 5 (severe akathisia). Fluvoxamine 100 mg/day was added to her treatment. Three weeks after adding fluvoxamine 100 mg/day treatment, there was no reemergence of akathisia or other extrapyramidal side effects.