scholarly journals Antipsychotic Drug-Induced Movement Disorders

2003 ◽  
Vol 30 (S1) ◽  
pp. S101-S107 ◽  
Author(s):  
Pierre J. Blanchet
Keyword(s):  
Movement Disorders ◽  
Antipsychotic Drugs ◽  
Involuntary Movement ◽  
Short Review ◽  
Central Place ◽  
Channel Blockers ◽  
Motor Complications ◽  
Drug Induced ◽  
Receptor Blocking ◽  
High Index Of Suspicion

Very early in the process of diagnosing abnormal involuntary movement (AIM) disorders, one can be rewarded by keeping a high index of suspicion for possible drug-induced causes, not only through a complete list of current medications, but also identification of the drugs the patient used to take and other possible offending medications that might be available from family members and other sources. Among drug-induced movement disorders, antipsychotic drugs and other dopamine receptor blocking agents occupy a central place. Their various acute and tardive motor complications provide the template of this short review. Movement disorders caused by antidepressants, lithium, antiemetics, antiparkinsonian agents, anticonvulsants, calcium channel blockers, sympathomimetics and others are only briefly covered in table form.

Delayed and Often Persistent

2016 ◽  
Author(s):  
Susan H. Fox
Keyword(s):  
Side Effects ◽  
Tardive Dyskinesia ◽  
Movement Disorder ◽  
Movement Disorders ◽  
Antipsychotic Drugs ◽  
Dopamine D2 Receptor ◽  
Treatment Options ◽  
D2 Receptor ◽  
Drug Induced ◽  
Tardive Dystonia

Tardive syndromes are drug-induced hyperkinetic movement disorders that occur as a consequence of dopamine D2 receptor antagonism/blockade. There are several types, including classical tardive dyskinesia, tardive dystonia, tardive tics, tardive myoclonus, and tardive tremor, and it is important to the management of these disorders that the type of movement disorder induced is identified. Tardive syndromes can occur with all antipsychotic drugs, including so-called atypical drugs. Patients taking these drugs should be evaluated frequently for side effects. Evaluating the nature of the movement (i.e., chorea or dystonia) is important because treatment options can differ according to the type of dyskinesia present.

Dyskinesias Associated with Tricyclic Antidepressants

1976 ◽  
Vol 128 (5) ◽  
pp. 490-493 ◽  
Author(s):  
William E. Fann ◽  
John L. Sullivan ◽  
Bruce W. Richman
Keyword(s):  
Side Effects ◽  
Tardive Dyskinesia ◽  
Movement Disorders ◽  
Antipsychotic Drugs ◽  
Tricyclic Antidepressants ◽  
Striatal Dopamine ◽  
Drug Induced ◽  
Anticholinergic Activity ◽  
Extrapyramidal Disorders

SummaryHyperkinetic movement disorders may occur as side effects of antipsychotic drugs; and a hyperdopaminergic state induced by the neuroleptic compounds is thought to be a cause of extrapyramidal disorders such as tardive dyskinesia. We have observed two cases of the dyskinetic syndrome in patients receiving tricyclic antidepressants (TCA). Because the TCA are known to have little effect on striatal dopamine but do share with the neuroleptics potent anticholinergic activity, these cases appear to support the hypothesis that the drug-induced hyperkinetic disorders are related to a diminution of CNS acetylcholine activity as well as to an increase in dopamine activity.

Drug-induced parkinsonism

2021 ◽  
Vol 13 (6) ◽  
pp. 91-97
Author(s):  
T. M. Ostroumova ◽  
O. D. Ostroumova ◽  
A. S. Soloveva
Keyword(s):  
Adverse Reaction ◽  
Movement Disorder ◽  
Antipsychotic Drugs ◽  
Channel Blockers ◽  
Drug Induced ◽  
Anticholinergic Activity ◽  
Common Drug ◽  
Naranjo Algorithm ◽  
Treatment Onset ◽  
Monoamine Reuptake Inhibitors

Drug-induced parkinsonism (DIP) is the most common drug-induced movement disorder and is most commonly associated with antipsychotic drugs, monoamine reuptake inhibitors, and calcium channel blockers. DIP manifests as a typical movement disorder, which makes it practically indistinguishable from idiopathic Parkinson's disease (PD) and requires differential diagnosis. DIP symptoms develop fairly quickly (hours to weeks) after the antipsychotic is started or after the dose is increased. Therefore, DIP is predominantly a clinical diagnosis that must be kept in mind when a patient develops typical symptoms during treatment onset or increasing the dose of drugs that most often lead to such an adverse reaction (ADR). DIP evaluation includes using the Naranjo algorithm, which helps assess a causal relationship between drug intake and the development of parkinsonism symptoms. The primary DIP treatment is the reduction of the dose of the inducer drug, or its cancellation, or replacement with another drug. In patients with schizophrenia and antipsychotic-induced DIP, dose reduction, replacement with another medication, or prescription of a drug with anticholinergic activity may be possible. The awareness of the doctor and the patient about the possibility of developing this ADR is crucial in the prevention of DIP. Therefore, choosing a drug with the lowest risk of developing DIP is necessary for pharmacotherapy.

Tardive syndromes

2020 ◽  
Vol 20 (5) ◽  
pp. 368-376
Author(s):  
Eoin Mulroy ◽  
Bettina Balint ◽  
Kailash P Bhatia
Keyword(s):  
Clinical Practice ◽  
Movement Disorder ◽  
Movement Disorders ◽  
Treatment Approach ◽  
Current Knowledge ◽  
Breathing Patterns ◽  
Drug Induced ◽  
Receptor Blocking ◽  
Delayed Onset ◽  
Abnormal Breathing

Dopamine receptor-blocking antipsychotics, first introduced into clinical practice in 1952, were hailed as a panacea in the treatment of a number of psychiatric disorders. However, within 5 years, this notion was to be shattered by the recognition of both acute and chronic drug-induced movement disorders which can accompany their administration. Tardive syndromes, denoting the delayed onset of movement disorders following administration of dopamine receptor-blocking (and also other) drugs, have diverse manifestations ranging from the classic oro-bucco-lingual dyskinesia, through dystonic craniocervical and trunk posturing, to abnormal breathing patterns. Although tardive syndromes have been an important part of movement disorder clinical practice for over 60 years, their pathophysiologic basis remains poorly understood and the optimal treatment approach remains unclear. This review summarises the current knowledge relating to these syndromes and provides clinicians with pragmatic, clinically focused guidance to their management.

scholarly journals Drugs associated with DIP

2021 ◽  
pp. 109-118
Author(s):  
T. M. Ostroumova ◽  
O. D. Ostroumova ◽  
A. S. Soloveva
Keyword(s):  
Relative Risk ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antipsychotic Drugs ◽  
Lewy Bodies ◽  
Lithium Carbonate ◽  
Channel Blockers ◽  
Minimal Risk ◽  
Drug Induced ◽  
Extrapyramidal Disorders ◽  
Increased Risk

Drug-induced parkinsonism (DIP) is one of the most frequent extrapyramidal disorders that develops against the background of prescribing a large number of medications. Initially, DIP was described as an adverse drug reactions (ADRs) against the background of the use of antipsychotic drugs, but later recognized as ADRs of a number of other drugs, including prokinetics, antidepressants, calcium channel blockers and antiepileptic drugs. The relative risk of developing LIP on the background of taking typical antipsychotics increased by 2.92 times compared to patients who do not take these drugs. The risk of developing DIP in patients receiving flunarizine is increased by 2.75-4.07 times. The risk of DIP with the use of antidepressants is increased by 2.14 times, among the drugs of this group with an increased risk of DIP, the use of selective serotonin reuptake inhibitors is most often associated with DIP (relative risk 1.24). Among other antidepressants, there is evidence of the development of DIP against the background of the use of duloxetine, mirtazapine, amitriptyll clomipramine, venlafaxine, trazodone. Among anticonvulsants, DIP can rarely develop against the background of the appointment of valproic acid, gabapentin, pregabalin, carbamazepine, oxcarbazepine. The risk of DIP in patients receiving metoclopramide is extremely low (0.06%), but it is 2.16 times higher compared to people who do not take this drug. Among drugs from other groups, DIP can occur against the background of the use of lithium carbonate, tacrolimus, cyclosporine, amiodarone, captopril, amphotericin B. If DIP develops, it is necessary, if possible, to reduce the dose or cancel the inducer drug, or replace it with another drug with minimal risk of DIP. Symptoms of DIP most often regress within a few weeks or months after dose reduction or withdrawal of the drug inducer. If the symptoms persist longer, it is necessary to exclude the presence of Parkinson’s disease or dementia with with Lewy bodies.

Recognition of Movement Disorders in Psychiatry: Video Fragments

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
P.N. van Harten ◽  
H.W. Hoek
Keyword(s):  
Tardive Dyskinesia ◽  
Dopamine Receptor ◽  
Movement Disorders ◽  
Clinical Aspects ◽  
Drug Induced ◽  
Receptor Blocking ◽  
Tardive Dystonia ◽  
Blocking Agents ◽  
Somatic Disease ◽  
Psychiatric Syndrome

Movement disorders in psychiatry can be divided in those related to an underlying neurological or other somatic disease, related to a psychiatric syndrome, drug induced and psychogenic. In this workshop the typical clinical aspects of each of these movement disorders will be discussed and shown on video with the focus on drug induced. Drug induced can be divided in acute and tardive movement disorders. Acute movement disorders such as acute dystonia, akathisia, parkinsonism and mycoclonus, start short after taking dopamine receptor blocking agents, often an antipsychotic. Once recognized they are relatively easy to treat. Tardive movement disorders such as tardive dyskinesia and tardive dystonia start months or years after using dopamine receptor blocking agents. Treatment is often disappointing, therefore prevention is needed.

Commentary on the Modified Rogers Scale and the ‘Conflict of Paradigms' Hypothesis

1991 ◽  
Vol 158 (3) ◽  
pp. 337-339 ◽  
Author(s):  
Peter F. Liddle
Keyword(s):  
Movement Disorders ◽  
Antipsychotic Drugs ◽  
Motor Disorders ◽  
Drug Induced ◽  
Complex Disorders ◽  
The Will

The variety and complexity of schizophrenic movement disorders renders them difficult to assess. In particular, the complex disorders of motility that appear to reflect disturbance of the will demand an evaluation of the purpose of the movement. The difficulties of assessment are compounded by the fact that the antipsychotic drugs used to treat the illness can produce motor disorders that resemble the disorders intrinsic to the illness. In advancing his ‘conflict of paradigms' hypothesis, Rogers (1985) implied that emphasis on the distinction between intrinsic and drug-induced movement disorders might be misplaced because of overlap not only in the observable characteristics of these disorders, but also in the underlying neuropathology.

scholarly journals Etiology of parkinsonism in a Brazilian movement disorders clinic

1998 ◽  
Vol 56 (2) ◽  
pp. 171-175 ◽  
Author(s):  
FRANCISCO CARDOSO ◽  
SARAH T CAMARGOS ◽  
GERALDO A SILVA JR
Keyword(s):  
Multiple System Atrophy ◽  
Movement Disorders ◽  
Calcium Channel Blockers ◽  
Channel Blockers ◽  
Drug Induced ◽  
Clinical Criteria ◽  
Clinical Diagnoses ◽  
Geographic Differences ◽  
Previous Series

OBJECTIVE: The aim of the present study is to investigate whether there are geographic differences in the etiology of parkinsonism (PA). BACKGROUND: 72% of patients with PA evaluated at movement disorders clinics in the Northern Hemisphere are diagnosed with Parkinson's disease (PD). Data regarding other regions are not available. METHODS: We reviewed the charts of all patients with PA seen at the Federal University of Minas Gerais Movement Disorders Clinic from July 1993 through October 1995. PA was diagnosed by the presence of at least two of the following: rest tremor, bradykinesia, rigidity, and postural instability. The different etiologies were diagnosed based on standard clinical criteria RESULTS: During the period of the study, PA was recognized in 338 subjects. The following clinical diagnoses were made: PD (68.9%), drug-induced PA (DIP) (13.3%), vascular PA (4.7%), Progressive supranuclear palsy (PSP) (2%), multiple system atrophy (MSA) (1.8%), others (9.7%). Cinnarizine, haloperidol and flunarizine were the commonest drugs related to DIP. CONCLUSIONS: Similarly to other studies, PD accounts for about 70% of PA patients. However, there are differences between our results and previous series. DIP is much more common in the present series. This may be accounted for a more liberal use of antidopaminergic drugs in our environment, especially Calcium channel blockers. The lower frequency of MSA and PSP in our study may reflect a short follow-up, since many patients initially diagnosed with PD later are found to have Parkinson-plus syndromes.

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