Tardive Orofacial Dyskinesia due to Aripiprazole in the Treatment of Schizophrenia

Aim: To highlight tardive dyskinesia (TD) as a notable side effect of aripiprazole in the treatment of schizophrenia and discuss the potential therapeutic benefit of brexpiprazole as an alternative. Case Report: A 45-year-old male, diagnosed with schizophrenia, exhibited significant remission of psychotic symptoms after being treated with aripiprazole (10mg/day). However, after one year of consistent treatment, he developed tardive orofacial dyskinesia, characterized by lip-smacking and chewing motions. An extensive neurological evaluation with the aid of non-contrasted brain CT confirmed the TD diagnosis. Transitioning the patient from aripiprazole to brexpiprazole resulted in a cessation of TD symptoms within four months, with a continued stable remission of his psychotic symptoms. Conclusions: Despite its dopamine receptor partial agonism, which theoretically reduces the risk, aripiprazole can induce TD. It is crucial for clinicians to remain vigilant and monitor for TD even when prescribing second-generation antipsychotics like aripiprazole. In cases of aripiprazole-induced TD, brexpiprazole may offer an effective therapeutic alternative, warranting further research and attention.