A case of painless moving toes in a patient with chronic neuroleptic exposure illustrates how multiple medication changes complicate a symptomatic response.
The patient had repetitive toe curling and a history of tardive dyskinesia. Benztropine improved toe symptoms but was followed by orofacial movements. Amantadine was not tolerated, truncal movements appeared, and aripiprazole was replaced by quetiapine. Later clonazepam treatment was associated with improvement in toe and truncal movements.
This was not an isolated test of clonazepam for an otherwise unchanged toe-movement syndrome. Removing or changing a suspected causative drug, delayed effects of previous interventions, and variation in the movement disorder could contribute to the later improvement. One report cannot establish which action produced the benefit. The useful review question is how each movement phenotype aligned with each medication change, rather than treating the final response as proof that clonazepam alone resolved a fixed condition.
Original analysis of the supplied journal article, identified as PMC7195950.