Table 1.
Timelines of patient events and medications in current admission and follow-up
|
Date
|
Event
|
Medication/s
|
Comment
|
| July 2008 | Hospitalization | ROS 4 mg/d | First onset with delusion and auditory hallucination |
| November 2009 | TD | ROS 4 mg/d + Alp 0.4 mg qn + GBE | Psychotic symptoms resolved, but her bucco-linguo-masticatory syndrome appeared and could not be relieved by GBE |
| November 09-18, 2010 | Que 0.2 g/d + Alp 0.4 mg qn + GBE 1 tab bid + Vit E 0.1/d | TD was not relieved by switching ROS to Que and combining it with GBE and Vit E | |
| November 19, 2011 | Ola 10 mg/d + Alp 0.4 mg qn + GBE 1 tab bid + Vit E 0.1/d | TD was not relieved by switching Que to Ola and combining it with GBE and Vit E | |
| October 12, 2020 | Readmission | Ola 10 mg/d + PTZ 25 mg bid + THP 2 mg bid | TD was not relieved by a combination of PTZ and THP during hospitalization |
| October 21, 2020-June 08, 2022 | Que 0.2 g/d + PTZ 25 mg bid + Vit E 0.1/d | TD was not relieved by switching to Que and combining it with PTZ and Vit E | |
| June 09-11, 2022 | Readmission | Que 0.1 bid + DTB 6 mg bid + Vit E 0.1/d + PTZ 50 mg tid + Alp 0.4 mg qn | TD was slightly ameliorated when administered in combination with DTB after admission; however, her tongue could not be retracted into the mouth. Video 1 (June 10, 2022). Baseline: AIMS 31, PANSS 56, CGI 7. D3: AIMS 29, PANSS 56, CGI 6 |
| June 12-15, 2022 | Clo 25 mg/d + DTB 6 mg bid + Vit E 0.1/d + PTZ 25 mg tid + Lor 1 mg qn | TD was relieved remarkably after switching Que to Clo, and her tongue could now be retracted into the mouth. Video 2 (June 14. 2022) D7: AIMS 23, PANSS 52, CGI 4 | |
| July 16-19, 2021 | Clo 25 mg bid + DTB 6 mg bid + Vit E 0.1/d + PTZ 25 mg qn + Lor 1 mg qn + MECT for the first session | TD was ameliorated after combining MECT, and the tremor in her lower jaw was reduced. D10: AIMS 22, PANSS 48, CGI 3 | |
| July 20-22, 2021 | Clo 25 mg bid + DTB 6 mg bid + Vit E 0.1/d + MECT for the second session | TD did not worsen after stopping Lor and PTZ | |
| July 23, 2021 | Discharge | D14: AIMS 20, PANSS 48, CGI 3 | |
| July 24, 2021-now | Clo 25 mg bid + DTB 6 mg bid | TD did not worsen after stopping Vit E, and she could take a semi-fluid diet. Video 3 (December 26, 2022). D182: AIMS 20, PANSS 46, CGI 3 |
AIMS: Abnormal involuntary movement scale; Alp: Alprazolam; Clo: Clozapine; DTB: Deutetrabenazine; GBE: Ginkgo biloba extract; Lor: Lorazepam; MECT: Modified electroconvulsive therapy; Ola: Olanzapine; PANSS: Positive and Negative Syndrome Scale; PTZ: Promethazine; Que: Quetiapine; ROS: Risperidone oral solution; TD: Tardive dyskinesia; THP: Trihexyphenidyl; Vit E: Vitamin E.