Oculogyric crisis in two patients treated with aripiprazole for chronic tics

Andrea E Cavanna; Chiara Colangelo; Claudia Melina; Annachiara Ravasi; Gabriele Arienti; Anna Riva; Renata Nacinovich; Stefano Seri

doi:10.1007/s10072-026-09056-7

Oculogyric crisis in two patients treated with aripiprazole for chronic tics

Andrea E Cavanna
, Chiara Colangelo
, Claudia Melina
, Annachiara Ravasi
, Gabriele Arienti
, Anna Riva
, Renata Nacinovich
, Stefano Seri

University of Birmingham
Università degli Studi di Milano-Bicocca

Research output: Contribution to journal › Article › peer-review

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Abstract

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.

Original language	English
Article number	450
Number of pages	4
Journal	Neurological Sciences
Volume	47
Issue number	5
Early online date	23 Apr 2026
DOIs	https://doi.org/10.1007/s10072-026-09056-7
Publication status	Published - 23 Apr 2026

Bibliographical note

© The Author(s) 2026. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

Keywords

Tourette syndrome
Tics
Aripiprazole
Oculogyric Crisis

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10.1007/s10072-026-09056-7Licence: CC BY 4.0

Oculogyric crisis in two patients treated with aripiprazole for chronic tics
© The Author(s) 2026. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
Final published version, 653 KBLicence: CC BY 4.0

Cite this

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title = "Oculogyric crisis in two patients treated with aripiprazole for chronic tics",

abstract = "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.",

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AU - Ravasi, Annachiara

AU - Arienti, Gabriele

AU - Riva, Anna

AU - Nacinovich, Renata

AU - Seri, Stefano

N1 - © The Author(s) 2026. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

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N2 - 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.

AB - 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.

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Oculogyric crisis in two patients treated with aripiprazole for chronic tics

Abstract

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