Benefical Effects of Sigma-1 Agonist Fluvoxamine for Tardive Dyskinesia and Tardive Akathisia in Patients with Schizophrenia: Report of Three Cases
Mr M, a 41-year-old man, had been diagnosed with schizophrenia for 18 years. He had been treated with conventional antipsychotics as haloperidol, pimozide and zuclopenthixol for almost 13 years. For the last 5 years, he has been treated with olanzapine 20 mg/day and biperidene 4 mg/day. The results of MRI, EEG, blood chemistry, a complete blood count, and thyroid function tests were all normal. On psychiatric and physical examination, avolution, mood, anhedonia, insomnia, fatigue, difficulty concentrating and choreic movements on bilateral upper limbs were noted. The choreic movements has been existent for nearly seven years. Mr M was diagnosed with schizophrenia, residual type and medication induced movement disorder (tardive dyskinesia) according to the DSM-IV-TR. Ms A scored 11 on the AIMS. Fluvoxamine 100 mg/day was added to treatment. At the fourth week, the dyskinesia had improved gradually and observed to be improved in terms of tardive dyskinesia with on score of 3 on the AIMS.