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Treatment of psychotic and behavioral symptoms with clozapine, aripiprazole, and reboxetine in a patient with Huntington’s disease

Edlinger, Monikaa; Seppi, Klausb; Fleischhacker, Wolfganga; Hofer, Alexa

International Clinical Psychopharmacology: July 2013 - Volume 28 - Issue 4 - p 214–216
doi: 10.1097/YIC.0b013e328361e145
Case Report

We report on the successful use of a combined psychopharmacological treatment in a patient with Huntington’s disease, at age 39, suffering from severe psychotic and behavioral symptoms. He presented with a schizophreniform psychosis accompanied by aggressive behavior leading to admission to the locked ward of our hospital. After unsatisfactory control of the psychiatric symptoms with olanzapine, risperidone, and amisulpride, we introduced aripiprazole. This did not affect the psychotic symptoms; however, led to an improvement in aggressive behavior, motivation, and even chorea. Accordingly, we choose not to switch medication but to add clozapine. Nevertheless, his delusions improved slightly, and further add-on treatment with reboxetine brought a further beneficial effect on motivation and activities of daily living. As chorea was not disabling in our patient, tetrabenazine has not yet been tried. Treatment was safe without any relevant side effects

aDepartment of Psychiatry and Psychotherapy, Biological Psychiatry Division

bDepartment of Neurology, Medical University Innsbruck, Innsbruck, Austria

Correspondence to Monika Edlinger, MD, Department of Psychiatry and Psychotherapy, Biological Psychiatry Division, Medical University Innsbruck, Anichstr 35, A-6020 Innsbruck, Austria Tel: +43 512 504 23669; fax: +43 512 504 25267; e-mail:

Received January 11, 2013

Accepted March 28, 2013

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins