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A 68-year-old man with a long-standing history of schizoaffective disorder is referred to the clinic for abnormal movements. He reports that his neck becomes stuck and twisted and that it has been harder for him to write over the past 3 months. Medications include sertraline, venlafaxine, lithium, risperidone, and zolpidem. Examination demonstrates dystonic posturing of the neck with associated head tremor and writing-induced dystonia of the right hand<br><br>Which medication is likely responsible for his neurologic presentation?
Explanation
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This patient is likely experiencing tardive dystonia. Dystonia can be induced by the use of dopamine antagonist agents, including both typical and atypical antipsychotics. Risk factors for development of neuroleptic-induced tardive dystonia include older age of patient and length of treatment. In this case, the most likely agent causing the dystonia is risperidone. None of the other choices are traditionally considered to be dopamine-blocking medications
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Reference
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Morgante F, Klein C. Dystonia. Continuum (Minneap Minn). 2013 Oct19(5 Movement Disorders)1225-41. doi 10.121201.CON.0000436154.08791.67. PMID 24092288.
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Option 1
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Is Correct (Option 1):
Lithium
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Option 2
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Is Correct (Option 2):
Risperidone
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Option 3
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Is Correct (Option 3):
Sertraline
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Option 4
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Is Correct (Option 4):
Venlafaxine
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