Complications of tardive dyskinesia: A review

Yassa, Ramzy; Jones, Barry D.

doi:10.1016/s0033-3182(85)72863-0

Cited by 57 publications

(24 citation statements)

References 37 publications

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“…It appeared that the severe gasping contributed to the dysphagia and choking. Recently, the complications of TD have been reviewed (14). The development of aspiration pneumonia as a consequence of TD has not as far as we know been previously recorded.…”

Section: Discussionmentioning

confidence: 99%

Respiratory irregularity and tardive dyskinesia A prevalence study

Yassa

Lal

1986

Acta Psychiatr Scand

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In a survey of 351 chronically hospitalized adult psychiatric patients, clinical evidence of irregular respiration compatible with respiratory tardive dyskinesia was present in eight subjects (2.3%). In four, audible involuntary respiratory noises were present. All patients with respiratory irregularities had a facio-bucco-lingual dyskinesia and in four the dyskinesia also involved extremities and/or other regions of the body. The prevalence of respiratory irregularities amongst patients with tardive dyskinesia was eight out of 108 (7.4%); none of the patients without tardive dyskinesia had respiratory irregularities. The prevalence of respiratory irregularities was significantly greater in patients with an organic mental disorder (11.1%) compared with those without (1.3%) (P less than 0.005). None of the patients complained of their respiratory symptoms and none had been diagnosed as having a respiratory dyskinesia prior to the survey. In two patients the symptoms were severe, leading in one case to prominent gasping, dysphagia, severe choking when eating, and episodes of aspiration pneumonia. In a second patient the noisy respiration was interpreted as attention-seeking and intimidating behaviour which led to rejection by the staff. In the remaining six patients respiratory symptoms were relatively minor.

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Section: Discussionmentioning

confidence: 99%

Respiratory irregularity and tardive dyskinesia A prevalence study

Yassa

Lal

1986

Acta Psychiatr Scand

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“…While this article will concentrate on involuntary movements in adult psychotic patients, it is of particular recent concern that similar movement disorder is becoming increasingly recognized in children and adults with developmental disabilities/mental handicap, where evidence for a beneficial effect of neuroleptics is, at best, unclear (Campbell et al, 1983;Gualtieri and Sprague, 1984;Richardson et al, 1986); it is also now more frequently recognized in subjects given neuroleptic-related agents for gastrointestinal disorders (Wiholm et al, 1984). The classical movements of the buccal-lingual-masticatory region and the less common involvement of the limbs, thorax and trunk do not constitute a benign syndrome; rather, a variety of resultant medical and psychosocial complications have been described (Gerratt et al, 1984;Yassa and Jones, 1985).…”

Section: Introductionmentioning

confidence: 99%

Tardive dyskinesia in schizophrenia and other disorders: Associations with ageing, cognitive dysfunction and structural brain pathology in relation to neuroleptic exposure

Waddington

1987

Human Psychopharmacology

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Little is known of the processes which confer vulnerability to the emergence of involuntary movements (tardive dyskinesia) in only a proportion of patients receiving long-term treatment with neuroleptic drugs. There is no consistent evidence that patients with involuntary movements have received either longer or more vigorous pharmacotherapy, and it has proved difficult to demonstrate any general relationship between increasing neuroleptic exposure and the emergence of the syndrome. Advancing age may be associated more with deleterious changes in the central nervous system within individual patients that can raise vulnerability to the emergence of involuntary movements, than with particular predisposing patterns of neuroleptic exposure. The literature in schizophrenic patients reveals that two indirect and putative indices of 'organicity', namely cognitive dysfunction and negative schizophrenic symptoms, together with several CT indices of structural brain pathology, show similar and robust associations with the presence of involuntary movements. In schizophrenia, predisposition to the emergence of involuntary movements during long-term neuroleptic therapy appears intimately related with particular features of the illness, especially those associated with clinical deterioration. It is argued from clinical and animal studies that neuroleptics may hasten the appearance of dyskinetic movements in individuals with the greatest likelihood of ultimately having such movements spontaneously as cerebral deterioration proceeds.

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“…Can tardive dyskinesia (TD), a condition of potentially irreversible abnormal involuntary movements associated to treatment with D2 receptor antagonists (first‐generation antipsychotics, FGAs), and producing a significant impairment of functioning and quality of life, be considered relatively irrelevant for treatment with second‐generation antipsychotics (SGAs)?…”

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confidence: 99%

Tardive dyskinesia risk with first‐ and second‐generation antipsychotics in comparative randomized controlled trials: a meta‐analysis

et al. 2018

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Tardive dyskinesia (TD) risk with D2/serotonin receptor antagonists or D2 receptor partial agonists (second-generation antipsychotics, SGAs) is considered significantly lower than with D2 antagonists (first-generation antipsychotics, FGAs). As some reports questioned this notion, we meta-analyzed randomized controlled studies (RCTs) to estimate the risk ratio (RR) and annualized rate ratio (RaR) of TD comparing SGAs vs. FGAs and SGAs vs. SGAs. Additionally, we calculated raw and annualized pooled TD rates for each antipsychotic. Data from 57 head-to-head RCTs, including 32 FGA and 86 SGA arms, were meta-analyzed, yielding 32 FGA-SGA pairs and 35 SGA-SGA pairs. The annualized TD incidence across FGA arms was 6.5% (95% CI: 5.3-7.8%) vs. 2.6% (95% CI: 2.0-3.1%) across SGA arms. TD risk and annualized rates were lower with SGAs vs. FGAs (RR=0.47, 95% CI: 0.39-0.57, p<0.0001, k=28; RaR=0.35, 95% CI: 0.28-0.45, p<0.0001, number-needed-to-treat, NNT=20). Meta-regression showed no FGA dose effect on FGA-SGA comparisons (Z=-1.03, p=0.30). FGA-SGA TD RaRs differed by SGA comparator (Q=21.8, df=7, p=0.003), with a significant advantage of olanzapine and aripiprazole over other non-clozapine SGAs in exploratory pairwise comparisons. SGA-SGA comparisons confirmed the olanzapine advantage vs. non-clozapine SGAs (RaR=0.66, 95% CI: 0.49-0.88, p=0.006, k=17, NNT=100). This meta-analysis confirms a clinically meaningfully lower TD risk with SGAs vs. FGAs, which is not driven by high dose FGA comparators, and documents significant differences with respect to this risk between individual SGAs.

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Complications of tardive dyskinesia: A review

Cited by 57 publications

References 37 publications

Respiratory irregularity and tardive dyskinesia A prevalence study

Respiratory irregularity and tardive dyskinesia A prevalence study

Tardive dyskinesia in schizophrenia and other disorders: Associations with ageing, cognitive dysfunction and structural brain pathology in relation to neuroleptic exposure

Tardive dyskinesia risk with first‐ and second‐generation antipsychotics in comparative randomized controlled trials: a meta‐analysis

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