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Tardive Dyskinesia


Presentation

  • TD may present with nonchoreoathetoid symptoms that can be difficult to distinguish from acute EPS.[mdedge.com]
  • We know how to determine which claims have merit and how to present these complicated cases. No other firm in the country can compare to our experience with tardive dyskinesia â ” this is what we do.[mgmattorneys.com]
  • Tardive myoclonus, a rare disorder, presents as brief jerks of muscles in the face, neck, trunk, and extremities. [9] "AIMS Examination": This test is used when psychotropic medications have been prescribed because patients sometimes develop tardive dyskinesia[en.wikipedia.org]
  • Ethnicity and the course of tardive dyskinesia in outpatients presenting to the motor disorders clinic at the Maryland psychiatric research center. J Clin Psychopharmacol . 2004. December; 24 6 : 592- 598. [ PubMed ] [ Google Scholar ] 26.[ncbi.nlm.nih.gov]
Disability
  • Some have expressed the view that the majority of spontaneous late onset edentulous dyskinesias are actually a form of idiopathic torsion dystonia (Jankovic 1988, Jankovic and Fahn 1993), but the disability and appearance in this group of patients tends[oxfordmedicine.com]
  • "Tardive dyskinesia can be disabling and can further stigmatize patients with mental illness," said Mitchell Mathis, M.D., director of the Division of Psychiatry Products in the FDA’s Center for Drug Evaluation and Research.[fda.gov]
  • These may co-exist with classic TD symptoms, but may represent separate subtypes with increased risk of progression, persistence, and severe disability.[mdedge.com]
  • This means that literally millions of people and the public have received false reassurance from the mental health system about the risk of getting TD, which for some can be an extremely disfiguring lifetime disability.[mindfreedom.org]
  • Fuelled by the fear of rejection for being ‘mentally ill, I began to have disabling anxiety and nightmares.[heretohelp.bc.ca]
Nightmare
  • Fuelled by the fear of rejection for being ‘mentally ill, I began to have disabling anxiety and nightmares.[heretohelp.bc.ca]
Hoarseness
  • I have learned not to raise my voice or sing for more than a short time because I will become hoarse or develop a throat infection.[heretohelp.bc.ca]
Bruxism
  • It usually affects orofacial and lingual musculature (“buccolinguomasticatory syndrome”) with chewing; bruxism; protrusion, curling, or twisting of the tongue; lip smacking, puckering, sucking, and pursing; retraction, grimacing or bridling of the mouth[mdedge.com]
Blister
  • Because of all these movements, the inside of my mouth and the surface of my tongue are usually scraped, blistered and sore. At times I feel very self-conscious about my appearance.[heretohelp.bc.ca]
Fear
  • This made me extremely anxious and fearful that I was ruining my life and the lives of the ones I loved most. Fuelled by the fear of rejection for being ‘mentally ill, I began to have disabling anxiety and nightmares.[heretohelp.bc.ca]
Compulsive Disorder
  • disorder Drug- and toxin-induced movement disorders: Caffeine, phenytoin, estrogens, levodopa, dopamine agonists, antidepressants, antihistamines, stimulants, anticonvulsants, acute extrapyramidal side effects and transient withdrawal dyskinesias associated[mdedge.com]
Distractibility
  • Dyskinesias increase with emotional arousal, activation, or distraction, and diminish with relaxation, sleep, or volitional effort.[mdedge.com]
Anger
  • […] a “short-term” solution, I was prescribed a tiny amount of thioridazine (an antipsychotic and sedative medication), which was replaced by trifluoperazine (an antipsychotic and antianxiety medication) to control nightmares, anxiety and my increasing anger[heretohelp.bc.ca]
Confusion
  • I had become weepy, confused and depressed shortly after the birth of my daughter.[heretohelp.bc.ca]
Ataxia
  • Wilson’s disease, parkinsonian syndromes, Hallervorden-Spatz disease, Fahr’s syndrome, globus pallidus and spinocerebellar degenerations, lysosomal storage diseases, aminoacidurias, mitochondrial disorders, neuroacanthocytosis, Lesch-Nyhan syndrome, ataxia[mdedge.com]
Catatonia
  • […] postanoxic or traumatic lesions of the basal ganglia, partial or nonconvulsive seizure disorders Metabolic disorders: Hyperthyroidism, hypoparathyroidism, chorea gravidarum Psychiatric disorders: Spontaneous dyskinesias associated with schizophrenia and catatonia[mdedge.com]
Choreoathetoid Movements
  • Choreoathetoid movements of the fingers, hands, or upper or lower extremities also are common. Patients may experience axial symptoms affecting the neck, shoulders, spine, or pelvis.[mdedge.com]

Workup

Prolonged QT Interval
  • Its use should be avoided in patients with congenital long QT syndrome or with abnormal heartbeats associated with a prolonged QT interval.[fda.gov]

Treatment

  • TD often is suppressed or masked by ongoing antipsychotic treatment and becomes apparent only when the drug is reduced, switched, or discontinued.[mdedge.com]
  • Tardive dyskinesia in patients treated with atypical antipsychotics: case series and brief review of etiologic and treatment considerations. Drugs Context . 2014.[ncbi.nlm.nih.gov]
  • "New and emerging treatments for symptomatic tardive dyskinesia". Drug Design, Development and Therapy. 7 : 1329–40. doi : 10.2147/DDDT.S32328. PMC 3825689. PMID 24235816. Alexander, C; Power, P (2008).[en.wikipedia.org]
  • Patients who suffer from movement disorders early in the course of dopamine antagonist treatment are more likely to develop tardive dyskinesia. Tardive dyskinesia is more common among smokers than non-smokers.[healthengine.com.au]
  • Patients were modeled to be impacted by events such as withdrawal of TD symptoms, cessation of treatment, disease progression and death.[n.neurology.org]

Prognosis

  • […] palsy, Tourette syndrome, dystonia [2] Prevention Using lowest possible dose of neuroleptic medication [3] Treatment Stopping neuroleptic medication if possible, switching to clozapine [1] Medication Valbenazine, tetrabenazine, botulinum toxin [1] [4] Prognosis[en.wikipedia.org]

Etiology

  • Tardive dyskinesia in patients treated with atypical antipsychotics: case series and brief review of etiologic and treatment considerations. Drugs Context . 2014.[ncbi.nlm.nih.gov]

Epidemiology

  • Despite its fairly widespread prevalence, there is scant literature reporting the epidemiology of TD. Design/Methods: A model was created to estimate the epidemiology of TD.[n.neurology.org]
  • "Epidemiology of tardive dyskinesia before and during the era of modern antipsychotic drugs". In Vinken, P. J.; Bruyn, G. W. (eds.). Handbook of Clinical Neurology.[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology and drug therapy of tardive dyskinesia: current concepts and future perspectives. Drugs Today (Barc) . 2003. January; 39 1 : 19- 49. [ PubMed ] [ Google Scholar ] 4. Jensen N, Oliveira JRM.[ncbi.nlm.nih.gov]

Prevention

  • Prevention Because there is no “gold standard” treatment for TD, it is important to minimize the risk of TD by taking preventive measures and detecting incipient signs of the disorder.[mdedge.com]
  • [ edit ] Prevention of tardive dyskinesia is achieved by using the lowest effective dose of a neuroleptic for the shortest time.[en.wikipedia.org]
  • In general terms, one should aim to use the lowest possible dose of a neuroleptic agent for the shortest possible time to prevent tardive dyskinesia.[healthengine.com.au]

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