Tardive Syndromes Research Articles

The Neuropharmacology of Tardive Dyskinesia, Spontaneous Dyskinesia, and Other Dystonias

Most classifications of movement disorders emphasize their differential diagnosis and epidemiology according to clinical history and neurological examination. This review of movement disorders is organized according to the hypothesis of basal ganglia neurotransmitter imbalance in order to emphasize current research based on the pharmacology of these disorders. Specifically, dopamine (DA) excess and acetylcholine (ACh) deficiency may characterize part of the pathology of several hyperkinetic movement disorders including tardive dyskinesia, Huntington disease, Gilles de la Tourette syndrome, l-dopa dyskinesias, tardive Tourette syndrome, and toxic Tourette syndrome. The mirror image of this paradigm, namely DA deficiency and ACh excess, may characterize several rigid-dystonic movement disorders including Parkinson disease, drug-induced dystonias, and dystonia musculorum deformans. Finally, the unique combination of DA excess with ACh excess may characterize idiopathic orofacial dyskinesia (also known as Meige dystonia, Brueghel syndrome, and blepharospasm-oromandibular dystonia). Evidence supporting this formulation of movement disorders is reviewed, the limitations of this hypothesis are discussed, and new data from our own studies are presented.

Changing epidemiology of tardive dyskinesia: an overview.

Dyskinesia is found significantly more often among neuroleptic-treated psychiatric patients than among non-neuroleptic-treated patients. The epidemiology of tardive dyskinesia is changing; its reported prevalence among neuroleptic-treated psychiatric inpatients has been progressively rising and has reached 25% during the past five years. The prevalence of persistent tardive dyskinesia that may be attributable to neuroleptics is about 13%. Tardive dyskinesia is not restricted to old, brain-damaged inpatients but also occurs with a noticeable frequency among younger patients, including outpatients, treated neuroleptics. Yet neuroleptics are the most effective available treatment for schizophrenia; hence, any drastic curtailment of their use in the treatment of chronic schizophrenic patients may not be justified. Cautious use of these drugs, along with intensified research on tardive dyskinesia is warranted.

A rating scale for tardive dyskinesia.

A rating scale for tardive dyskinesia was developed, consisting of nearly all signs seen by two groups of investigators over a 5-year period. Thirty-four items were included in the scale with a possibility of writing in idiosyncratic signs. The scale was shown to have good reliability and validity in studies carried out by both the New York and Boston groups. It is recommended as a suitable instrument for describing the breadth of tardive dyskinesia syndrome and also for quantifying the disorder. A second scale, "the abbreviated dyskinesia scale", contains 13 items which are more global than the items in the original scale. It also has been shown to be both reliable and valid. Its use is suited to situations requiring less extensively detailed assessments.

Tardive dyskinesia: are first signs reversible?

Although tardive dyskinesia, a serious and sometimes irreversible side effect of antipsychotic drug use, is becoming increasingly common, there is still considerable confusion concerning the course of the syndrome. The authors observed 12 psychiatric patients with tardive dyskinesia from the inception of the syndrome. They found that first symptoms rarely persisted if antipsychotics were discontinued and concluded that the length of time symptoms have persisted prior to drug discontinuation, not age at onset, may be the major variable determining reversibility of the syndrome.

Persistent muscular restlessness after phenothiazine treatment: report of 3 cases.

Back to table of contents Previous article Next article ArticleNo AccessPERSISTENT MUSCULAR RESTLESSNESS AFTER PHENOTHIAZINE TREATMENT: REPORT OF 3 CASESWALTER KRUSEWALTER KRUSESearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.117.2.152AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "PERSISTENT MUSCULAR RESTLESSNESS AFTER PHENOTHIAZINE TREATMENT: REPORT OF 3 CASES." American Journal of Psychiatry, 117(2), pp. 152–153 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByExpanding phenomenologic heterogeneity of tardive syndromes: Time for an updated assessment toolParkinsonism & Related Disorders, Vol. 77A unifying theory for the pathoetiologic mechanism of tardive dyskinesiaMedical Hypotheses, Vol. 140The Assessment and Treatment of Antipsychotic-Induced Akathisia23 April 2018 | The Canadian Journal of Psychiatry, Vol. 63, No. 11Journal of the Neurological Sciences, Vol. 389Tardive Dyskinesias24 February 2012Current Treatment Options in Neurology, Vol. 13, No. 3, Vol. 100, Vol. 95Acta Medica Scandinavica, Vol. 170, No. 6Drug-Induced Movement Disorders30 June 2016 | Journal of Pharmacy Practice, Vol. 20, No. 6The Consultant Pharmacist, Vol. 22, No. 2Tardive dyskinesia in geriatric patientsAging Health, Vol. 2, No. 5The Consultant Pharmacist, Vol. 21, No. 1Movement Disorders, Vol. 9, No. 2, Vol. 20045530The Barnes Akathisia Rating Scale–Revisited2 July 2016 | Journal of Psychopharmacology, Vol. 17, No. 4Comprehensive Psychiatry, Vol. 37, No. 2Biological Psychiatry, Vol. 31, No. 4Clonazepam treatment of tardive dyskinesia: a practical GABAmimetic strategy1 April 2006 | American Journal of Psychiatry, Vol. 147, No. 4Biological Psychiatry, Vol. 27, No. 4International Review of Psychiatry, Vol. 2, No. 3-4Movement Disorders, Vol. 4, No. 2Psychiatric Clinics of North America, Vol. 9, No. 1Sustained improvement in tardive dyskinesia with diazepam: Indirect evidence for corticolimbic involvementBrain Research Bulletin, Vol. 11, No. 2Annals of Neurology, Vol. 13, No. 4Treatment of tardive dyskinesia with diazepam: Indirect evidence for the involvement of limbic, possibly GABA-ergic mechanismsBrain Research Bulletin, Vol. 5Acta Psychiatrica Scandinavica, Vol. 46, No. 1Tardive Dyskinesia in Patients Treated with Major Neuroleptics: A Review of the LiteratureGEORGE E. CRANE1 April 2006 | American Journal of Psychiatry, Vol. 124, No. 8SOn the Rarity of "Irreversible" Oral Dyskinesias Following PhenothiazinesNATHAN S. KLINE1 April 2006 | American Journal of Psychiatry, Vol. 124, No. 8SPhenothiazine BibliographiesJournal of the American Geriatrics Society, Vol. 15, No. 6Acta Psychiatrica Scandinavica, Vol. 43, No. 3Archiv f�r Psychiatrie und Nervenkrankheiten Vereinigt mit Zeitschrift f�r die Gesamte Neurologie und Psychiatrie, Vol. 208, No. 4A Controlled Study of the Use of Thioridazine in the Treatment of Hyperactive and Aggressive Children in a Children's Psychiatric Hospital26 April 2017 | Canadian Psychiatric Association Journal, Vol. 9, No. 3Acta Psychiatrica Scandinavica, Vol. 40, No. 1Acta Psychiatrica Scandinavica, Vol. 40, No. 1 Volume 117Issue 2 August 1960Pages 152-153 Metrics PDF download History Published online 1 April 2006 Published in print 1 August 1960