CYP2D6 genetic polymorphism and extrapyramidal side effects of antipsychotic drugs

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.

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Myalgia and Elevated Creatine Kinase Associated with Rosiglitazone; Diltiazem-Induced Eosinophilic Pleural Effusion; Reversible Leukoencephalopathy with Carboplatin; Another Platinum Derivative ADR – Renal Tubular Acidosis; Oxcarbazepine and Pancytopenia; Two Cases of Acute Laryngeal Dystonia Associated with Ziprasidone; Extrapyramidal Side Effects with Atypical Antipsychotic Drugs used in Bipolar Disorder

Hospital Pharmacy ◽

10.1310/hpj4206-501 ◽

2007 ◽

Vol 42 (6) ◽

pp. 501-504 ◽

Cited By ~ 3

Author(s):

Joel Shuster

Keyword(s):

Bipolar Disorder ◽

Creatine Kinase ◽

Side Effects ◽

Pleural Effusion ◽

Renal Tubular Acidosis ◽

Antipsychotic Drugs ◽

Extrapyramidal Side Effects ◽

Renal Tubular ◽

Eosinophilic Pleural Effusion ◽

Platinum Derivative

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Applied monitoring for tardive dyskinesia and other extrapyramidal side effects

Mental Health Clinician ◽

10.9740/mhc.n92483 ◽

2012 ◽

Vol 1 (7) ◽

pp. 159-163 ◽

Cited By ~ 1

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.

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