Oculogyric crisis in two patients treated with aripiprazole for chronic tics

Background: Oculogyric crisis and other acute dystonic reactions have been reported as a rare adverse effect of aripiprazole, a third-generation antidopaminergic medication used for the treatment of multiple neuropsychiatric conditions, including psychotic disorders, affective disorders, obsessive-compulsive disorder, and neurodevelopmental disorders. Case description: We document two cases (two females aged 16 and 22 years) diagnosed with a neurodevelopmental tic disorder (Tourette syndrome), who developed oculogyric crisis while taking medium/high-dose aripiprazole 20-30 mg daily as a first-line anti-tic agent. Their acute dystonic manifestations completely regressed following dose reduction of aripiprazole. Discussion: Aripiprazole-induced oculogyric crisis has previously been reported in a total of 18 cases (9 females, age range 11–28 years). Of these, only two (an 18-year-old male and a 21-year-old female) were taking aripiprazole for their tic disorder. In addition to further documenting treatment-emergent oculogyric crisis in patients with Tourette syndrome taking aripiprazole for the treatment of their tics, our reports raise the possibility of dose-dependent mechanisms underlying the development of oculogyric crisis, at least in selected cases.