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.

scholarly journals Amisulpiride induced tardive dyskinesia: a case report

2018 ◽  
Vol 6 (11) ◽  
pp. 3779
Author(s):  
Dhananjay Chaudhari ◽  
Ganesh Shanker ◽  
Kunjan Gupta
Keyword(s):  
Case Report ◽  
Side Effects ◽  
High Risk ◽  
Tardive Dyskinesia ◽  
Movement Disorders ◽  
Atypical Antipsychotics ◽  
Dopamine D2 Receptor ◽  
D2 Receptor ◽  
Blood Levels ◽  
Typical Antipsychotics

Amisulpride is a bezamide group of antipsychotic, and like other antipsychotics, it acts by reducing signalling via the dopamine D2 receptor. It is associated with a high risk, of developing increased blood levels of the lactation hormone, prolactin and low risk, as compared with typical antipsychotics, of causing movement disorders. Tardive dyskinesia is a type of movement disorder, which is more common with typical antipsychotics but development of tardive dyskinesia is not rare with the use of atypical antipsychotics. Newer molecules are being developed to reduce the incidence of various dyskinesias, but side effects are evident even with relatively newer molecules. Amisupride is also classed with newer generation of atypical antipsychotic, used to treat schizophrenia and dysthymia. We are reporting a case of middle aged female patient suffering from schizophrenia who developed tardive dyskinesia with the use of amisulpride.

scholarly journals Differentiating tardive dyskinesia: a video-based review of antipsychotic-induced movement disorders in clinical practice

CNS Spectrums ◽  
2020 ◽  
pp. 1-10
Author(s):  
Robert A. Hauser ◽  
Jonathan M. Meyer ◽  
Stewart A. Factor ◽  
Cynthia L. Comella ◽  
Caroline M. Tanner ◽  
...  
Keyword(s):  
Tardive Dyskinesia ◽  
Movement Disorders ◽  
Treatment Options ◽  
Mood Stabilizers ◽  
Drug Induced ◽  
Parkinsonian Tremor ◽  
Stabilizing Agents ◽  
Appropriate Treatment ◽  
History Of ◽  
Abnormal Behaviors

Abstract Accurate diagnosis and appropriate treatment of tardive dyskinesia (TD) are imperative, as its symptoms can be highly disruptive to both patients and their caregivers. Misdiagnosis can lead to incorrect interventions with suboptimal or even deleterious results. To aid in the identification and differentiation of TD in the psychiatric practice setting, we review its clinical features and movement phenomenology, as well as those of other antipsychotic-induced movement disorders, with accompanying links to illustrative videos. Exposure to dopamine receptor blocking agents (DRBAs) such as antipsychotics or antiemetics is associated with a spectrum of movement disorders including TD. The differential diagnosis of TD is based on history of DRBA exposure, recent discontinuation or dose reduction of a DRBA, and movement phenomenology. Common diagnostic challenges are the abnormal behaviors and dyskinesias associated with advanced age or chronic mental illness, and other movement disorders associated with DRBA therapy, such as akathisia, parkinsonian tremor, and tremor related to use of mood stabilizing agents (eg, lithium, divalproex). Duration of exposure may help rule out acute drug-induced syndromes such as acute dystonia or acute/subacute akathisia. Another important consideration is the potential for TD to present together with other drug-induced movement disorders (eg, parkinsonism, parkinsonian tremor, and postural tremor from mood stabilizers) in the same patient, which can complicate both diagnosis and management. After documentation of the phenomenology, severity, and distribution of TD movements, treatment options should be reviewed with the patient and caregivers.

scholarly journals Drug-Induced Tardive Dyskinesia

2021 ◽  
Vol 8 (9) ◽  
pp. 413-422
Author(s):  
Marianto Marianto ◽  
Hartono Kosim ◽  
I Made Wedastra
Keyword(s):  
Tardive Dyskinesia ◽  
Movement Disorder ◽  
Movement Disorders ◽  
Drug Induced ◽  
Comprehensive Management ◽  
Delay In Treatment

Drug-induced movement disorders could be classified into acute, subacute, and chronic based on the time of occurrence. Tardive dyskinesia (TD) is one of the most frequent long-term drug-induced movement disorders. Delay in treatment often caused TD to be irreversible. In this review, we will discuss TD in-depth to enhance clinician knowledge regarding the diagnosis, prevention, and comprehensive management of patients with TD. Keywords: tardive dyskinesia, movement, disorder, antipsychotic.

scholarly journals Diagnostic Challenges Revealed from a Neuropsychiatry Movement Disorders Clinic

2012 ◽  
Vol 39 (6) ◽  
pp. 782-788 ◽  
Author(s):  
Heather Rigby ◽  
Angela Roberts-South ◽  
Hrishikesh Kumar ◽  
Leonardo Cortese ◽  
Mandar Jog
Keyword(s):  
Tardive Dyskinesia ◽  
Movement Disorder ◽  
Movement Disorders ◽  
Drug Induced ◽  
Optimal Care ◽  
Rater Reliability ◽  
Abnormal Movements ◽  
Psychiatric Conditions ◽  
Referring Physicians ◽  
Made In

Background:Abnormal movements are frequently associated with psychiatric disorders. Optimized management and diagnosis of these movements depends on correct labeling. However, there is evidence of reduced accuracy in the labeling of these movements, which could result in sub-optimal care.Objective:To determine the consensus inter-rater reliability between a movement disorders neurologist and physicians referring from the community for phenomenology and diagnoses of individuals with co-existing psychiatric conditions and movement disorders.Method:Charts of all consecutive patients seen in a combined Movement Disorders and Neuropsychiatry Clinic between 2001-2009 were reviewed retrospectively. Consensus estimates and kappa values for inter-rater reliability were determined for phenomenology and diagnostic terms for the respective referring source and movement disorders neurologist for each patient.Results:A total of 106 charts were reviewed (62 men and 44 women). Agreement for phenomenology terms ranged from 0% (psychogenic) to 73% (tremor). Only 3 terms had kappa values that met or exceeded criteria for moderate inter-rater reliability. Agreement for diagnosis terms was highest for tardive dyskinesia (83%), drug induced tremor (33%), and drug induced parkinsonism (20%). In 18 of the 22 charts (82%), a diagnosis was made of drug induced movement disorder (DIMD) by the referring physician. In contrast, a diagnosis of DIMD was made in only 54 of 106 charts (51%) after the patients were assessed in the clinic.Conclusions:A movement disorders specialist frequently disagreed with referring physicians' identification of patient phenomenology and diagnosis. This suggests that clinicians would benefit from educational resources to assist in characterizing abnormal movements.

Investigation of chemical interactions of small peptides and vitamin substances at the developed dopamine D2 receptor models

2017 ◽  
Vol 41 (S1) ◽  
pp. S366-S366
Author(s):  
R. Aslancan ◽  
B. Aksoydan ◽  
I. Kantarcioglu ◽  
I. Erol ◽  
R.E. Salmas ◽  
...  
Keyword(s):  
Molecular Modeling ◽  
Side Effects ◽  
Active Sites ◽  
Antipsychotic Drugs ◽  
Dopamine D2 Receptor ◽  
D2 Receptor ◽  
Small Peptides ◽  
Significant Information ◽  
Dopamine D2 ◽  
Competing Interest

IntroductionDopamine receptors perform various functions essential to vertebrate central nervous systems and they are the major targets of antipsychotic drugs. Our recent studies pioneered to perform molecular modeling studies of the dopamine D2 receptor (D2R), describing the mechanism and binding affinities of marketed antipsychotics into the active sites of the D2highR and D2LowR [1]. Another study provided significant information about changes of binding cavity properties of D2R [2].ObjectivesSince the marketed antipsychotics have serious side effects, we aim to explore ligands with better inhibition profiles on D2R with less unwanted outcomes. For this aim, we compare the effectiveness of the marketed drugs with small peptides and vitamin substances.AimsThe main goal of the research is to explore novel small molecules that inhibit D2R to be used in schizophrenia.MethodsIn this study, we used a large number of endogen vitamins and peptides with dopamine D2R active-inactive forms in monomeric-dimeric patterns to understand their interactions at the active sites of targets. Nineteen of antipsychotic drugs, which are widely used in schizophrenia treatment are selected as reference molecules. Molecular docking, molecular screening and molecular modeling approaches were used.ResultsSome of these endogen molecules showed similar or better inhibition profiles on D2R compared to the known standard inhibitors of the target.ConclusionsProposed molecules may be potent for D2 receptor inhibition with less side effects for the use for schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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.

scholarly journals Aripiprazole in Tardive Dyskinesia: Is it a Safe Choice?

2017 ◽  
Vol 08 (02) ◽  
pp. 294-295 ◽  
Author(s):  
Nimisha Doval ◽  
Soumitra Das ◽  
Vikas Moun
Keyword(s):  
Tardive Dyskinesia ◽  
Movement Disorder ◽  
Mechanism Of Action ◽  
Movement Disorders ◽  
First Generation ◽  
Third Generation ◽  
Middle Aged ◽  
Prolonged Administration ◽  
Drug Induced

ABSTRACTTardive dyskinesia (TD) is a potentially irreversible drug-induced movement disorder associated with prolonged administration of antipsychotics. Conventionally, first generation antipsychotics were the agents thought to have a higher risk of TD as compared to second and third generation antipsychotics. Aripiprazole is a third generation antipsychotic with a novel mechanism of action, and until recently, cases of drug-induced movement disorders were less well known with it. But off late, several cases of TD with aripiprazole have been reported. We present here a case of middle-aged women with preexisting tardive movements, which exacerbated with aripiprazole use and reduced in frequency and intensity on withdrawal of the drug.

scholarly journals High dose antipsychotic polypharmacy and dopamine partial agonists - time to rethink guidelines?

2021 ◽  
pp. 026988112110264
Author(s):  
Gavin P Reynolds
Keyword(s):  
Side Effects ◽  
Dopamine D2 Receptor ◽  
D2 Receptor ◽  
Receptor Site ◽  
Receptor Occupancy ◽  
Antipsychotic Agents ◽  
High Dose ◽  
Partial Agonists ◽  
Favourable Side Effect Profile ◽  
Different Characteristics

Guidelines for the treatment of schizophrenia limit the use of antipsychotic agents to clinically-established maximum doses. This acknowledges both the absence of additional efficacy of dopamine D2 receptor antagonists above a receptor occupancy threshold, and the increases in side effects that can occur at higher doses. These limits restrict the dosing of combinations of antipsychotics as they do single agents; drugs sharing the major antipsychotic mechanism of D2 receptor antagonism will act additively in blocking these receptors. Several newer antipsychotic drugs, including aripiprazole and cariprazine, act as partial agonists at the D2 receptor site and avoid action at several other receptors, effects at which are responsible for some non-dopaminergic adverse effects. This pharmacology imparts different characteristics to the drugs resulting often in a more favourable side effect profile. Their partial agonism, along with high affinities for the D2 receptor, also means that these drugs given adjunctively may in part replace, rather than enhance, the D2 antagonism of other antipsychotic agents. This can result in an improvement in certain side effects without loss of antipsychotic efficacy. This article makes the case for distinguishing the D2 partial agonists from antagonists in defining maximum doses of combined treatments, which would increase the options available to the prescriber, emphasising that pharmacological mechanisms need to be understood in identifying optimal treatments for psychotic illness.

scholarly journals A QM protein–ligand investigation of antipsychotic drugs with the dopamine D2 Receptor (D2R)

2017 ◽  
Vol 36 (10) ◽  
pp. 2668-2677 ◽  
Author(s):  
Ramin Ekhteiari Salmas ◽  
Yusuf Serhat Is ◽  
Serdar Durdagi ◽  
Matthias Stein ◽  
Mine Yurtsever
Keyword(s):  
Antipsychotic Drugs ◽  
Dopamine D2 Receptor ◽  
D2 Receptor ◽  
Dopamine D2
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