{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:44:15Z","timestamp":1791380655048,"version":"4.3.3"},"reference-count":5,"publisher":"MedWorks Media","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychopharmacol Bull"],"abstract":"<jats:p>Objectives\nYoung patients with intellectual disability (ID) have both diagnostic and therapeutic challenges. These include, inter alia, diagnostic overshadowing, diagnostic slippage and heightened vulnerability to adverse drug reactions. These would portent a generally poor prognostication.\nMethods\nThis is a case-study of an adolescent with intellectual disability long-hospitalized for co-morbid treatment-resistant bipolar mood disorder that failed to respond to ECT. Patient partially responded to LAI risperidone with repeated ADRs. Top-up with low-dose clozapine (100 mg\/d) was pursued.\nResults\nLow-dose clozapine top-up complemented therapeutic response (mood lability and paranoia) and strikingly safeguarded effectively against risperidone-related extrapyramidal side effects.\nConclusions\nAdd-on clozapine remains a viable option, albeit off-label, in young patients with ID and treatment-resistant affective\/schizophreniform psychoses. Clozapine has an edge over other agents in the setting of dyskinesias.<\/jats:p>","DOI":"10.64719\/pb.4438","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T11:39:16Z","timestamp":1761046756000},"page":"161-164","source":"Crossref","is-referenced-by-count":2,"title":["Top-Up Clozapine for Risperidone LAI-Related Acute Dystonia and TR Bipolar in an Adolescent with ID-Putting the Cart before the Horse?"],"prefix":"10.64719","volume":"52","author":[{"given":"Ahmed","family":"Naguy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saxby","family":"Pridmore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anubhuti","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibi","family":"Alamiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54175","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Hanagasi HA, Bilgic B, Gurvit H et al. Clozapine Treatment in Oromandibular Dystonia. Clin Neuropharmacol. 2004;27(2):84086.","DOI":"10.1097\/00002826-200403000-00007"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Naguy A, Moodliar-Rensburg S, Alamiri B. Clozapine-Associated Hypothyroidism. Am J Ther. 2020 doi: 10.1097\/MJT.000000000001244. Doi: Online ahead of print.","DOI":"10.1097\/MJT.000000000001244"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Naguy A, Elsori D. Metformin for Antipsychotic-Related Metabolic Syndrome in Children: Fact or Fiction. Chin Med J (Engl). 2018;131(12):1490\u20131491.","DOI":"10.4103\/0366-6999.233944"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Naguy A, Alamiri B, Khraibut B. Weight Loss During Atomoxetine Add-on to Clozapine-Responsive Schizophrenia. Am J Ther. 2018;25(6):e774\u2013e775.","DOI":"10.1097\/MJT.0000000000000785"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Naguy A. A Comment on \u2018Successful Management of Clozapine-induced Akathisia with Gapapentin Enacarbil: A Case Report\u2019. Clin Psychopharmacol Neurosci. 2019;17(4):564\u2013565.","DOI":"10.9758\/cpn.2019.17.4.564"}],"container-title":["Psychopharmacology Bulletin"],"original-title":[],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:31:06Z","timestamp":1791315066000},"score":1,"resource":{"primary":{"URL":"https:\/\/medworksmedia.com\/pb-article\/top-up-clozapine-for-risperidone-lai-related-acute-dystonia-and-tr-bipolar-in-an-adolescent-with-id-putting-the-cart-before-the-horse\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,12]]},"references-count":5,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,8,12]]}},"URL":"https:\/\/doi.org\/10.64719\/pb.4438","relation":{},"ISSN":["2472-2448"],"issn-type":[{"value":"2472-2448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,12]]}}}