Three cases of improvement of tardive dyskinesia following olanzapine treatment

To date, clozapine is the only antipsychotic agent that has established itself as having minimal, if any, risk of tardive dyskinesia (TDk). In patients with TDk, clozapine permits the dyskinesia to disappear in approx. 50% of cases, particularly those with dystonic features, i.e. tardive dystonia (TDt) (Gardos, 1999). Unfortunately, clozapine is not always efficacious. Furthermore, some patients cannot be treated with clozapine because of its side-effects. Olanzapine is a serotonin-dopamine-receptor antagonist, which has an affinity for neuroreceptors similar to that of clozapine. Pooled tolerability data from controlled trials show that the overall incidence of TDk in patients treated with olanzapine is significantly lower than in patients treated with haloperidol (Tollefson et al., 1997). Here, we report three cases of patients affected by tardive disorders who dramatically improved after olanzapine treatment.