Aripiprazole Effects on Psychosis and Chorea in a Patient With Huntington’s Disease

“Mr. A” was a 47-year-old single man who suffered from frequent falls as a result of an unsteady gait and involuntary movements over the past 4 years. He was diagnosed with Huntington’s disease but refused treatment. Approximately 2 years before his current evaluation, he began to demonstrate impairment in activities of daily living and talking to himself. He also developed irritability, persecutory delusions, and intermittent violent behavior toward his family. Obvious choreiform movements and unsteady gait were noted when the patient was admitted to the acute psychiatric ward. His family history was positive for Huntington’s disease, with an elder brother who was bedridden and a sister who died from the disease. His medical history showed that he had only received irregular treatment with risperidone orally (1–3 mg per day) during a 2-week period. Aripiprazole (10 mg per day) was started and increased to 20 mg per day. Subsequently, his personal hygiene and psychotic symptoms were significantly improved within 2 weeks. His choreiform movement decreased significantly, and his gait became stable, enabling him to walk smoothly without assistance. Before treatment with aripiprazole, his score on the chorea sub-item of the Unified Huntington’s Disease Rating Scale was 18. After treatment, his score decreased to 8.