Tardive Dyskinesia: Outcome of Antipsychotic Treatment and Brain Damage?

2021 ◽  
pp. 1-12
Author(s):  
Richard M. Kostrzewa ◽  
Ryszard Brus ◽  
John P. Kostrzewa
Keyword(s):  
Tardive Dyskinesia ◽  
Brain Damage ◽  
Antipsychotic Treatment

Tardive Dyskinesia: Outcome of Antipsychotic Treatment and Brain Damage?

2014 ◽  
pp. 2315-2326 ◽  
Author(s):  
Richard M. Kostrzewa ◽  
John P. Kostrzewa ◽  
Ryszard Brus
Keyword(s):  
Tardive Dyskinesia ◽  
Brain Damage ◽  
Antipsychotic Treatment

Antipsychotic-induced supersensitivity – A reappraisal

2021 ◽  
pp. 000486742110256
Author(s):  
William Lugg
Keyword(s):  
Tardive Dyskinesia ◽  
Significant Proportion ◽  
Underlying Mechanism ◽  
Antipsychotic Treatment ◽  
Physiological Changes ◽  
Antipsychotic Therapy ◽  
Neurotransmitter Systems ◽  
Potential Benefits ◽  
Treatment Refractory ◽  
Brain Pathways

Objectives: Tardive dyskinesia, psychotic relapse and treatment-refractory psychosis have long been associated. A common underlying mechanism involving antipsychotic-induced ‘supersensitivity’, albeit in different brain pathways, was proposed as early as 1978. This piece seeks to reappraise the concept and potential implications of antipsychotic-induced supersensitivity. Conclusions: Evidence increasingly suggests that chronic antipsychotic exposure induces neuroadaptive physiological changes in dopaminergic, and other, neurotransmitter systems that may render some individuals more vulnerable to psychotic relapse - including those receiving continuous antipsychotic treatment. It is possible that in treating every episode of psychosis with prolonged or indefinite antipsychotic therapy, we paradoxically increase the risk of psychotic relapse in a significant proportion of people. A greater appreciation of supersensitivity may allow us to optimise any potential benefits of antipsychotics while minimising the risk of inadvertent iatrogenic harms. More research is needed to improve our understanding of the underlying neurophysiology of supersensitivity and to better identify which individuals are most vulnerable to its development. It is time we paid more attention to the concept, emerging evidence and potential implications of antipsychotic-induced supersensitivity and, where appropriate, adjusted our practice accordingly.

Incidence of Tardive Dyskinesia and Tardive Dystonia in African Caribbean Patients on Long-Term Antipsychotic Treatment

2006 ◽  
Vol 67 (12) ◽  
pp. 1920-1927 ◽  
Author(s):  
Peter N. van Harten ◽  
Hans W. Hoek ◽  
Glenn E. Matroos ◽  
Jim van Os
Keyword(s):  
Tardive Dyskinesia ◽  
Antipsychotic Treatment ◽  
Tardive Dystonia ◽  
African Caribbean

scholarly journals Brain damage and tardive dyskinesia

1995 ◽  
Vol 167 (3) ◽  
pp. 410-411 ◽  
Author(s):  
A. Al-Adwani
Keyword(s):  
Tardive Dyskinesia ◽  
Brain Damage

Effects of Antipsychotic Treatment on Tardive Dyskinesia

2005 ◽  
Vol 66 (09) ◽  
pp. 1130-1133 ◽  
Author(s):  
Diederik E. Tenback ◽  
Peter N. van Harten ◽  
Cees J. Slooff ◽  
Mark A. Belger ◽  
Jim van Os ◽  
...  
Keyword(s):  
Tardive Dyskinesia ◽  
Antipsychotic Treatment

Informing patients about tardive dyskinesia

1998 ◽  
Vol 172 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Robert Chaplin ◽  
Andrew Kent
Keyword(s):  
Informed Consent ◽  
Clinical Outcome ◽  
Tardive Dyskinesia ◽  
Educational Intervention ◽  
Low Risk ◽  
Control Group ◽  
Antipsychotic Treatment ◽  
Random Allocation ◽  
Consent To Treatment ◽  
Clinical Stability

BackgroundThis paper evaluates the effects on knowledge and clinical stability of an educational intervention about tardive dyskinesia.MethodFifty-six patients receiving antipsychotic maintenance completed a questionnaire assessing their knowledge about tardive dyskinesia. After random allocation to either an educational intervention or a control group, their knowledge was reassessed at six months.ResultsNinety-five per cent of patients completed the study. The study patients gained significantly more knowledge than the controls, who made modest gains. There were no significant differences in clinical outcome between the groups.ConclusionPatients can learn about serious toxic effects of antipsychotic treatment with a low risk of non-compliance. Discussion about tardive dyskinesia is necessary in the process of obtaining informed consent to treatment.

scholarly journals 6 Presence and Impact of Possible Tardive Dyskinesia in Patients Prescribed Antipsychotics: Results from the RE-KINECT Study

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 176-177
Author(s):  
Andrew J. Cutler ◽  
Stanley N. Caroff ◽  
Caroline M. Tanner ◽  
Huda Shalhoub ◽  
William R. Lenderking ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Tardive Dyskinesia ◽  
Antipsychotic Treatment ◽  
Health State ◽  
Involuntary Movements ◽  
Body Regions ◽  
Abnormal Movements ◽  
Lifetime Exposure ◽  
The Impact

AbstractObjectiveTardive dyskinesia (TD) is a hyperkinetic movement disorder associated with antipsychotic treatment. RE KINECT (NCT03062033), a real-world study of outpatients prescribed antipsychotics, was designed to identify the presence of possible TD and characterize the impact of involuntary movements on functioning and quality of life. Data from RE-KINECT were used to compare the impact of possible TD in patients with schizophrenia/schizoaffective disorder [SZD] versus mood/other psychiatric disorders [Mood].MethodsAdults with ≥3months of lifetime exposure to antipsychotics and ≥1 psychiatric disorder were recruited. The presence of possible TD was based on clinicians’ observation of involuntary movements in 4 body regions (head, trunk, upper extremities, and lower extremities). Baseline outcomes included demographics, medication history, location/severity of abnormal movements, impact of abnormal movements on daily activities, the Sheehan Disability Scale (SDS), and the EuroQoL 5-Dimensional questionnaire (EQ-5D-5L).ResultsOf 204 patients with clinician-confirmed possible TD, 111 (54.4%) had a SZD diagnosis and 93 (45.6%) had a mood/other psychiatric diagnosis. Significant differences found between groups (Mood vs SZD) included: mean age (56.9 vs 52.7 years; P=0.0263); male sex (33.3% vs 62.2%; P<0.0001); African-American race (7.5% vs 26.1%; P=0.0005); mean lifetime exposure to antipsychotics (9.5 vs 19.5 years; P<0.0001); and percentage of patients currently taking ≥2 psychiatric medications (93.5% vs 79.3%; P=0.0093). Based on clinician observation, there were no significant differences between diagnosis groups in the number of body regions impacted by abnormal movements, maximum severity score across all 4 regions, or patient awareness of possible TD. Over 30% of patients in both groups reported that involuntary movements had “some” or “a lot” of impact on their ability to continue usual activities, be productive, and socialize. No significant differences between the diagnosis groups (Mood vs SZD) were found for mean SDS total score (12.8 vs 10.8), SDS domain scores (work/school [4.1 vs 4.2], social life [4.3 vs 3.7], family life [4.1 vs 3.5]), EQ-5D-5L utility score (0.68 vs 0.74), or EQ-5D-5L health state VAS (64.8 vs 68.5).ConclusionsIn this cohort of outpatients with possible TD, those with Mood disorders were more likely to be older, female, and white than patients with SZD. The ability to function and quality of life were equally impaired in both groups. Further studies on the impact of TD are needed.Funding Acknowledgements: Neurocrine Biosciences, Inc.

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