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Dystonia, a serious side effect of antipsychotic drugs, has two kinds of acute and chronic (tardive). The tardive kind has been the focus of attention recently, but a proved therapy has not been found. This kind is more serious and has poorer prognosis than the early onset type. The patient who is presented, is a man with 23 years of age who was hospitalized for the first time in 2002 while having paranoid schizophrenia symptoms. During the same period he has recieved antipsychotic drugs (Rispridon, perphenazin) and after being discharged, just a daily dose of 16 mg perphenazin was used. Since March of 2003 he has been afflicted with progressive neck tilting which was very disturbing and troublesome and was hospitalized with the diagnosis of tardive dystonia. The proposed drugs in psychiatric refrences were not effective finally he received ECT for 6 sessions which showed dramatic improvement. There was no relapse of symptoms after discharging the patient and restarting antipsychotic drug (Clozapin). There has not been any relapse in his dystonia afterward. The purpose of this article was to introduce an effective treatment for tardive dystonia.

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Background and Objective: Electroconvulsive therapy (ECT) is one of the most common methods in treatment of different types of psychological disorder. The effectiveness of this therapy has a direct relation with the duration of convulsion. This study was conducted to assess the effect of lidocaine on duration of seizure and hemodynamic alterations in electroconvulsive therapy. Materials and Methods: This clinical trial study was conducted on 72 ASA-I, II patients with psychotic disorders in Hajar Medical Center in Shahrekord, Iran during 2010. The patients randomly divided into intervention and control group. The interventional group was received 1.5 mg/kg lidocaine and controls were received normal saline. For induction of anesthesia, all patients were received Sodium Thiopental (2mg/kg), Succinylcholine (1mg/kg) and Atropine (0.5mg) Propofol and Succinylcholine during 72 sessions of ECT. Duration of objective convulsion and hemodynamic alterations including blood pressure and heart rate were recorded (before, immediately and 3, 5 minutes after ECT). Data were analyzed using SPSS-11.5 and t-test. Results: Systolic and diastolic blood pressures and heart rate in 3rd minutes in interventional group following electroconvulsive therapy were 143.38±16 mmHg, 79.86±6.7 mmHg, 91.9±9.9 mmHg, respectively and in controls were 128.88±13.04 mmHg, 87.63±5.79 mmHg and 102.86±13 mmHg, respectively. These difference were significant (P<0.05). The above-mentioned indices for 5th minutes in intervention and controls were as follow: systolic (113.47±9.97 mmHg, 122.36±13 mmHg), diastolic (73.47±4.27 mmHg, 77.63±6.26 mmHg) heart rate (84.41±4.6 in minute, 93.19±12.53 in minute). These differences in above indices were significant (P<0.05). Conclusion: This study showed that lidocaine administration during electroconvulsive therapy increase the duration of convulsion and reduces heart rate and blood pressure.