Amitriptyline induced tardive dyskinesia in a patient with cirrhotic Parkinsonism

Abstract

Cirrhotic Parkinsonism is classically seen in patients who present with recurrent hepatic encephalopathy in the presence of hyperammonemia and large porto-systemic shunts. Shunt occlusion procedures are usually performed in medically refractive cases. Here in, we present the case of such a patient, in who, after shunt occlusion procedure, initiation of Amitriptyline led to development of severe tardive dyskinesia features, diagnosed clinically. Removal of offending agent and appropriate therapy led to reversal of the syndrome.