This case report presents a 25-year-old female with tardive dyskinesia and tardive dystonia, which were refractory to valbenazine treatment. The patient, previously diagnosed with bipolar disorder and treated with antipsychotics, developed symptoms such as right-sided neck dystonia and oral dyskinesia after switching from quetiapine to lurasidone. After unsuccessful attempts with various therapies, the patient was admitted for electroconvulsive therapy (ECT), which significantly improved her symptoms, reducing her Abnormal Involuntary Movement Scale score from 10 to 2 after 12 sessions.

A literature review was conducted, encompassing 27 studies that included 50 patients treated with ECT for tardive dyskinesia and tardive dystonia. The review found that 84% of patients with tardive dyskinesia and 91% with tardive dystonia showed partial or full responses to ECT. However, the effects of ECT were variable, with some patients experiencing only temporary relief, while others had prolonged improvement. Despite the promising results, the exact mechanism of ECT’s efficacy in treating these conditions remains unclear. The study highlighted the need for further research, particularly randomized controlled trials, to better understand the role of ECT in managing treatment-resistant tardive dyskinesia and dystonia.

Reference: Irinaka K, Itoh Y, Yoshizawa K, et al. Successful Electroconvulsive Therapy for Tardive Dyskinesia and Tardive Dystonia Refractory to Valbenazine Treatment: A Case Report and Narrative Literature Review. Clin Psychopharmacol Neurosci. 2024;22(4):688-696. doi: 10.9758/cpn.24.1185.