Propranolol (inderal) for tardive dyskinesia and extrapyramidal side effects from neuroleptics: Possible involvement of beat - adrenergic mechanisms

1981 ◽  
Vol 4 (6) ◽  
pp. 627-632 ◽  
Author(s):  
Robert Wilbur ◽  
Frank A Kulik
Keyword(s):  
Side Effects ◽  
Tardive Dyskinesia ◽  
Extrapyramidal Side Effects ◽  
Adrenergic Mechanisms

Tardive Dyskinesia: A Concern for the Pediatrician

PEDIATRICS ◽  
1986 ◽  
Vol 77 (4) ◽  
pp. 553-556
Author(s):  
HARVEY S. SINGER
Keyword(s):  
Side Effects ◽  
Tardive Dyskinesia ◽  
Children And Adolescents ◽  
Behavior Disorders ◽  
Antipsychotic Drugs ◽  
Extrapyramidal Side Effects ◽  
Body Movements ◽  
Neuroleptic Therapy

Antipsychotic drugs, such as the phenothiazines (chlorpromazine, fluphenazine, thioridazine), butyrophenones (haloperiodol), and diphenylbutylpiperidines (pimozide) are used in children and adolescents to treat a variety of clinical entities including psychoses, tics, behavior disorders, and movement problems. Because virtually all of these drugs have a potential to affect body movements and posture, they have also been termed neuroleptics.1 Most physicians are aware of the more common acute extrapyramidal side effects of these drugs, such as oculogyria, pseudoparkinsonism, dystonia, and restlessness (akathisia). Despite the widespread use of neuroleptics, however, little is known about the long-term neurologic consequences of such treatment. Of particular concern, based originally on data in adults, is the risk of severe and persistent tardive dyskinesia developing in persons receiving neuroleptic therapy.

Applied monitoring for tardive dyskinesia and other extrapyramidal side effects

2012 ◽  
Vol 1 (7) ◽  
pp. 159-163 ◽  
Author(s):  
John E. Kalachnik
Keyword(s):  
Side Effects ◽  
Early Detection ◽  
Tardive Dyskinesia ◽  
Antipsychotic Drugs ◽  
Standard Of Care ◽  
Magic Bullet ◽  
Assessment Instruments ◽  
Extrapyramidal Side Effects ◽  
Antipsychotic Medications ◽  
Prevention Model

While the rate of tardive dyskinesia (TD) and other extrapyramidal side effects (EPSE) is lower with second generation antipsychotic medications compared to first generation antipsychotic medications, these side effects remain of clinical concern. This paper reviews the basis for the continued concern and the importance of secondary prevention, or early detection, within the primary-secondary-tertiary prevention model. The importance of standardized assessment instruments, education, and training is reviewed. Given the widespread use of antipsychotic drugs, the fact that antipsychotic drugs are the standard of care for several psychiatric conditions (with little indication that the magic bullet is on the immediate horizon to replace current antipsychotic drugs) applied monitoring and the early detection of TD and EPSE takes on added importance.

Prevalence of Extrapyramidal Side Effects in Patients Receiving Depot Antipsychotic Medication

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
B. Luft ◽  
E. Berent
Keyword(s):  
Side Effects ◽  
Tardive Dyskinesia ◽  
Antipsychotic Medication ◽  
Rating Scales ◽  
Involuntary Movement ◽  
Extrapyramidal Side Effects ◽  
Drug Induced ◽  
Adherence To Medication ◽  
Depot Antipsychotic ◽  
Long Acting

Introduction:Long-acting depot antipsychotic medication is associated with extrapyramidal side effects (EPS). This may reduce adherence to medication, and precipitate relapse (1). Clearly, EPS is a major drawback and early detection is essential. However, in an earlier review of patients’ medical notes, we identified only one patient with an examination that recorded the presence of EPS. Despite the fact that a number of rating scales are available. We proposed that the application of these rating scales, would allow us to improve the assessment of EPS.Method:All patients prescribed a depot antipsychotic or long-acting risperidone injection, were identified. the Barnes Akathisia Scale (2) was chosen to rate akathisia, a modified Simpson-Angus scale (3) was chosen to rate parkinsonism and the Abnormal Involuntary Movement Scale (4) was chosen to rate tardive dyskinesia.Results:A total of 43 patients were evaluated. 23 (53%) patients showed drug induced EPS. the total number of positive cases of akathisia was 12 (28%), and 10 (23%) patients were found to have tardive dyskinesia. 13 (30%) patients were found to have drug induced parkinsonism.Conclusions:Our screening programme has identified high rates of previously undiscovered drug induced EPS.

scholarly journals Antipsychotic-induced extrapyramidal side effects: A systematic review and meta-analysis of observational studies

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257129
Author(s):  
Tilahun Ali ◽  
Mekonnen Sisay ◽  
Mandaras Tariku ◽  
Abraham Nigussie Mekuria ◽  
Assefa Desalew
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Tardive Dyskinesia ◽  
Publication Bias ◽  
Psychotic Disorders ◽  
Meta Analysis ◽  
Extrapyramidal Side Effects ◽  
Bias Analysis ◽  
Pharmacological Management ◽  
Early Management

Background Antipsychotic agents are the basis for the pharmacological management of acute and chronic schizophrenia, bipolar disorders, mood disorders with psychotic feature, and other psychotic disorders. Antipsychotic medication use is frequently associated with unfavorable adverse effects such as extrapyramidal side effects (EPSEs). Hence, this systematic review and meta-analysis was aimed to determine the magnitude of antipsychotic-induced EPSEs. Method A literature search was conducted using legitimate databases, indexing services, and directories including PubMed/MEDLINE (Ovid®), EMBASE (Ovid®), google scholar and WorldCat to retrieve studies. Following screening and eligibility, the relevant data were extracted from the included studies using an Excel sheet and exported to STATA 15.0 software for analyses. The Random effects pooling model was used to analyze outcome measures at a 95% confidence interval. Besides, publication bias analysis was conducted. The protocol has been registered on PROSPERO with ID: CRD42020175168. Result In total, 15 original articles were included for the systematic review and meta-analysis. The pooled prevalence of antipsychotic-induced EPSEs among patient taking antipsychotic medications was 37% (95% CI: 18–55%, before sensitivity) and 31% (95% CI: 19–44%, after sensitivity). The prevalence of antipsychotic-induced parkinsonism, akathisia, and tardive dyskinesia was 20% (95% CI: 11–28%), 11% (95% CI: 6–17%), and 7% (95% CI: 4–9%), respectively. To confirm a small-study effect, Egger’s regression test accompanied by funnel plot asymmetry demonstrated that there was a sort of publication bias in studies reporting akathisia and tardive dyskinesia. Conclusion The prevalence of antipsychotic-induced EPSEs was considerably high. One in five and more than one in ten patients experienced parkinsonism and akathisia, respectively. Appropriate prevention and early management of these effects can enhance the net benefits of antipsychotics.

Clozapine and D1/D2 Antagonism in Extrapyramidal Functions

1992 ◽  
Vol 160 (S17) ◽  
pp. 34-37 ◽  
Author(s):  
Jes Gerlach ◽  
Lars Hansen
Keyword(s):  
Side Effects ◽  
Tardive Dyskinesia ◽  
Side Effect ◽  
Receptor Blockade ◽  
Biochemical Profile ◽  
Extrapyramidal Side Effects ◽  
Receptor Function ◽  
Extrapyramidal Side Effect ◽  
Extrapyramidal Syndromes

One of the main advantages of clozapine is that it rarely produces extrapyramidal syndromes and tardive dyskinesia. This advantage is linked to the atypical biochemical profile of clozapine, especially its combined and low blockade of D1 and D2 receptors. The level of D2 receptor blockade is too low to induce extrapyramidal side-effects, and D1 antagonists have a lower extrapyramidal side-effect potential than traditional D2 neuroleptics, especially with respect to dystonia. The combined and balanced D1/D2 receptor blockade may prevent the development of a dysbalance between D1/D2 receptor function (in favour of D1) which otherwise might lead to tardive dyskinesia.

Dopamine Blockers (“Antipsychotics”)

2018 ◽  
pp. 101-126
Author(s):  
S. Nassir Ghaemi
Keyword(s):  
Metabolic Syndrome ◽  
Clinical Pharmacology ◽  
Weight Gain ◽  
Side Effects ◽  
Tardive Dyskinesia ◽  
Drug Class ◽  
Acute Mania ◽  
Psychotic Symptoms ◽  
Extrapyramidal Side Effects ◽  
Bipolar Illness

The drug class of dopamine blockers includes agents called antipsychotics. It consists of dopamine blockers, often with serotonin blockade. Dopamine blockers are agents used to treat psychotic symptoms such as delusions and hallucinations. These medications have been developed mostly for use in schizophrenia, but they always have been found to be effective in acute mania as well. For the latter reason, they have been used in bipolar illness as well. Several of these agents have been proven effective in the depressive phase of bipolar illness, not just the manic phase. Also, some of them have been shown to be effective in the depressive phase of unipolar mood illness. The clinical pharmacology of specific agents within each class of dopamine blockers, including efficacy and side effects, is explored. Specific phenomena surveyed include metabolic syndrome, weight gain, extrapyramidal side effects, Parkinsonism, akathisia, and tardive dyskinesia.

scholarly journals Low dose typical antipsychotics – a brief evaluation

2000 ◽  
Vol 24 (12) ◽  
pp. 465-468 ◽  
Author(s):  
David Taylor
Keyword(s):  
Side Effects ◽  
Tardive Dyskinesia ◽  
Atypical Antipsychotics ◽  
Low Dose ◽  
Cognitive Symptoms ◽  
Extrapyramidal Side Effects ◽  
First Choice ◽  
Typical Antipsychotics

Atypical antipsychotics have, according to some, revolutionised the treatment of schizophrenia. These drugs are claimed to be better tolerated than older typical drugs largely because of their lower propensity to cause acute extrapyramidal side-effects (EPSE). Some atypicals cause little or no hyperprolactinaemia. Some are suggested to cause less tardive dyskinesia than typical drugs. Many are claimed to improve, to a relatively greater extent, negative and cognitive symptoms of schizophrenia. In addition, one atypical, clozapine, is unarguably more effective than typical drugs in the treatment of refractory schizophrenia. Atypical drugs are now sometimes recommended as first choice treatment for schizophrenia (Lieberman, 1996; Taylor et al, 2000).

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