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.

Extrapyramidal Syndromes and New Antipsychotic Drugs: Findings in Patients and Non-human Primate Models

1996 ◽  
Vol 168 (S29) ◽  
pp. 32-39 ◽  
Author(s):  
Daniel E. Casey
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Antipsychotic Drugs ◽  
Side Effect Profile ◽  
Neuroleptic Drugs ◽  
Extrapyramidal Side Effects ◽  
Primary Mode ◽  
Neuroleptic Therapy ◽  
Extrapyramidal Syndromes ◽  
Human Primate

Since neuroleptic drugs were introduced in the 1950s they have become the primary mode of therapy for managing both acute and chronic psychoses. Although some antipsychotic drugs are free of disturbing extrapyramidal side-effects (EPS), most have a very narrow therapeutic/toxic index. Clozapine is the best example of an antipsychotic with a wide separation between antipsychotic actions and liability to EPS, but its side-effect profile of sedation, salivation, seizures, and agranulocytosis are factors that limit its use, and clearly indicate the need for further advancement in neuroleptic therapy.

The management of tardive dyskinesia

1986 ◽  
Vol 24 (7) ◽  
pp. 27-28
Keyword(s):  
Tardive Dyskinesia ◽  
Antipsychotic Drugs ◽  
Disease Process ◽  
Neuroleptic Drug ◽  
Blocking Drug ◽  
Unwanted Effect ◽  
Difficult Condition ◽  
The Face ◽  
Schizophrenic Patients

Dyskinesias are involuntary movements usually of the face and tongue and sometimes of the limbs and trunk. Tardive (delayed) dyskinesia occurs in patients who have been taking an antipsychotic (neuroleptic) drug or, rarely, another central dopamine-receptor-blocking drug such as metoclopramide. It generally occurs only in those treated for longer than a year, although much shorter exposures have been implicated with the antipsychotics. A similar dyskinesia occurred in schizophrenic patients before antipsychotic drugs were introduced, and can occur in healthy untreated elderly people; risk factors include old age, brain damage1 and the schizophrenic disease process.2 Nevertheless, in most patients on an antipsychotic drug (whether psychotic or not), tardive dyskinesia is an unwanted effect of the drug. It occurs in 5–40% of patients on long-term antipsychotic medication.3–5 we discuss here advances in the management of this difficult condition since our last review.6

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.

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