Ayla Uzun Cicek 1 , Cicek Hocaoglu 2 , Tuna Ozmen 3 DOI: 10.14744/DAJPNS.2020.00111 Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2020;33:429-432 How to cite this article: Uzun Cicek A, Hocaoglu C, Ozmen T. Risperidone-induced tardive dystonia in a 10 years old boy and the efficacy of aripiprazole: a case report. Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2020;33:429-432. Risperidone-induced tardive dystonia in a 10 years old boy and the efficacy of aripiprazole: a case report 1 Asst. Prof. Dr. Cumhuriyet University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Sivas - Turkey 2 Professor Dr. Recep Tayyip Erdogan University, Training and Research Hospital, Department of Psychiatry, Rize - Turkey 3 Specialist of Neurology, Fatih State Hospital, Department of Neurology, Trabzon - Turkey Correspondence: Dr. Ayla Uzun Cicek, Sivas Cumhuriyet University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, 58140, Sivas - Turkey E-mail: dr.f.ayla@hotmail.com Received: March 31, 2020; Revised: August 21, 2020; Accepted: September 26, 2020 ABSTRACT Tardive dystonia (TDt) is one of the extrapyramidal syndromes caused primarily by long-term use of dopamine receptor antagonists such as antipsychotics. Although the risperidone-induced TDt cases have been reported in adults, there are few case reports and clinical anecdotes in children. The first step in treatment is the controlled withdrawal of the drug causing the TDt and, if necessary, a transition to a newer “atypical” antipsychotic class. In this article, we present a case of risperidone- induced tardive dystonia and the efficacy of aripiprazole in a 10-years-old boy with moderate mental retardation and conduct disorder referred to us due to restlessness, aggression, self-mutilation, and leg and hip spasms. The child’s dystonic symptoms and challenging behaviors almost fully recovered 3 months of after the aripiprazole administration. Given that the long-term use of antipsychotics in children is increasingly widespread, TDt should be evaluated and monitored periodically. Furthermore, aripiprazole may be a suitable substitute in the TDt treatment in children. Keywords: Aripiprazole, child, risperidone, tardive dystonia CASE REPORT INTRODUCTION Tardive Dystonia (TDt) is a movement disorder that affects the extremities, trunk, neck, or face, and develops as a side effect of long-term antipsychotic treatment. Sustained muscle spasms caused abnormal postures, repetitive twisting or rotating movements, or both. Some potential risk factors for the development TDt are chronic use of antipsychotics, younger age, male sex, previous brain injury, early extrapyramidal symptoms (EPS), intellectual disability, and mood disorders. The prevalence of TDt is about 3% of patients receiving long-term antipsychotic treatment. Unlike tardive dyskinesia, TDt develops in a shorter period of time, following antipsychotic medication and with significantly less cumulative antipsychotic intake. The duration of exposure to antipsychotic medications required to precipitate tardive dystonia varies from months to years (1-3). TDt can be overlooked in pediatric patients since atypical antipsychotics are less likely to cause tardive syndromes than typical antipsychotics (3) and there are few case reports in children compared to adults (4). In this report, we present a 10-year-old boy with risperidone-induced tardive dystonia. Our aim is to describe the characteristics, management, and treatment of TDt, and to demonstrate the therapeutic effects of aripiprazole on dystonic symptoms in this patient