# Withdrawal Dyskinesia Associated With Aripiprazole in a Child: A Case Report

## TL;DR

A child with autism developed movement disorders after stopping aripiprazole, showing the need for caution when adjusting antipsychotic medications in children.

## Contribution

Reports a rare case of withdrawal dyskinesia in a child after aripiprazole discontinuation, highlighting under-recognized risks in pediatric patients.

## Key findings

- Oral dyskinesia occurred after aripiprazole discontinuation and reappeared after dose reduction.
- Dyskinesia resolved upon reinitiation of aripiprazole and gradually disappeared over months.
- Withdrawal dyskinesia may be underreported in children and could impact quality of life.

## Abstract

Atypical antipsychotics are considered to be better tolerated than typical antipsychotics; however, the risk of drug-induced movement disorders needs to be considered. Aripiprazole, a dopamine partial agonist, is one of the most frequently used atypical antipsychotics in children. In this report, we describe withdrawal dyskinesia after aripiprazole discontinuation in a child with autism spectrum disorder. The patient presented with oral dyskinesia after discontinuation of aripiprazole when he was 13 years old. Dyskinetic movements disappeared after reinitiation of aripiprazole. He developed oral dyskinesia again after a reduction of the aripiprazole dose when he was 14 years old. Dyskinesia gradually disappeared within a few months. Withdrawal dyskinesia associated with aripiprazole has been rarely reported in children. Moreover, there is no large study on the prevalence of dyskinesia associated with aripiprazole discontinuation either in adults or in children. However, relevant cases might be unreported, pretermitted, or regarded as akathisia or symptoms of attention-deficit hyperactivity disorder. The prevalence of withdrawal dyskinesia associated with aripiprazole, especially in children, may be more frequent than thought. Withdrawal dyskinesia is self-limited; however, such dyskinetic movements in children potentially result in irreversible effects that damage the quality of life. As such, physicians should be mindful when changing, reducing, or discontinuing antipsychotics in children.