Ethnicity and the Course of Tardive Dyskinesia in Outpatients Presenting to the Motor Disorders Clinic at the Maryland Psychiatric Research Center

Wonodi, Ikwunga; Adami, Helene; Cassady, Shawn L.; Sherr, Jay D.; Avila, Matthew T.; Thaker, Gunvant K.

doi:10.1097/01.jcp.0000144888.43449.54

Cited by 42 publications

(21 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…TD is potentially irreversible and has a prevalence of approximately 30% in patients chronically exposed to antipsychotics (Kane, et al, 1988;Glazer, 2000). Several risk factors such as age, female gender, Negroid race and co-morbidity with akathisia have been reported to predispose to TD (Kane, et al, 1988;Morgenstern and Glazer, 1993;van Harten, et al, 1998;Glazer, 2000;Wonodi, et al, 2004). However, this only accounts for a small amount of the variance in the occurrence of TD (Jeste and Caligiuri, 1993;Basile, et al, 2002) and hereditary predisposition may play a role as well (Weinhold, et al, 1981;Yassa and Ananth, 1981;Youssef, et al, 1989;Rosengarten, et al, 1994;Muller, et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

The role of dopamine D3, 5-HT2A and 5-HT2C receptor variants as pharmacogenetic determinants in tardive dyskinesia in African-Caribbean patients under chronic antipsychotic treatment

et al. 2008

View full text Add to dashboard Cite

Tardive dyskinesia (TD) is associated with polymorphisms of the dopamine D(3), serotonin 2A and 2C receptors (DRD3, HTR2A and HTR2C, respectively). This study investigated the possible relationship between TD and the polymorphisms Ser9Gly (DRD3), 102T>C (HTR2A), -1438G>A(HTR2A) and Cys23Ser (HTR2C) in African-Caribbean inpatients. One hundred and twenty-six patients under chronic antipsychotic treatment were genotyped. The assessment of TD was carried out with the abnormal involuntary movement scale (AIMS). The relationships between the carriership of the least frequent alleles and the respective orofaciolingual dyskinesia (TDof) (sum of the items 1-4 of the AIMS), limb-truncal dyskinesia (TDlt) (sum of items 5-7 of the AIMS) and TD (sum of items 1-7 of the AIMS) were analyzed with ANCOVA, comparing means with age as a covariate and stratification for carriers and non-carriers of the mutations. In addition, we conducted pre-planned t-tests to compare AIMS values of carriers of the combinations of alleles versus the corresponding non-carriers. In the study population, females with 9Ser carriership exhibited higher AIMS values than non-carriers. Male subjects with 9Ser carriership in combination with 23Ser or -1438A carriership exhibited higher AIMS values. In male patients also, the combination of 23Ser and -1438A carriership increased TD. The study clearly shows that the African-Caribbean population differs from the Caucasian population with regard to the association of TD with the polymorphisms studied and suggests that the association of TD with the studied polymorphisms of the 5-HT(2C) and probably of the 5-HT(2A) receptor are the result of a changed susceptibility of the patients, independent of the action of the antipsychotics on these receptors.

show abstract

Section: Introductionmentioning

confidence: 99%

The role of dopamine D3, 5-HT2A and 5-HT2C receptor variants as pharmacogenetic determinants in tardive dyskinesia in African-Caribbean patients under chronic antipsychotic treatment

et al. 2008

View full text Add to dashboard Cite

show abstract

“…The TD prevalences are detected as various ratios for different ethnicities. While some studies reported that Afro-Americans had high risk for TD, Asians were identified to have low risk (18).…”

Section: Introductionmentioning

confidence: 99%

Tardive dyskinesia in long term hospitalized patients with schizophrenia

Nalbant¹,

Can²,

Burhan³

et al. 2016

Dusunen Adam

View full text Add to dashboard Cite

Tardive dyskinesia in long term hospitalized patients with schizophreniaObjective: Tardive dyskinesia (TD) is a group of delayed-onset iatrogenic movement disorders caused by dopamine receptor-blocking agents. TD prevalence is estimated as 20-50% of all patients treated with neuroleptics. This study aimed to investigate the prevalence rate of TD in long-term hospitalized patients with schizophrenia. Method:We recorded age, gender, duration and type (first/second generation or mixed) of medication both at the time of interview and over preceding years. Dyskinesia was assessed by using the Abnormal Involuntary Movements Scale (AIMS). We also used the Simpson-Angus Scale for tardive parkinsonism.Akathisia was measured using the Barnes Akathisia Rating Scale (BARS).Results: Mean duration of the longest used antipsychotic was 206.63 months. Probable TD was found in 18 (22.5%) of patients. None of the patients had tardive akathisia. Relation between type of the longest used treatment and prevalence of TD was not statistically significant. Relationship between type of ongoing treatment and prevalence of TD was not determined statistically significant either. There was a statistically significant relationship between the mean age and TD.Discussion: Despite very long duration of antipsychotic use, 22.5% rate of prevalence is still lower than expected. This can be explained that these patients are under direct and close follow-up of healthcare providers and in hospital conditions, so that risky conditions can be intervened rapidly. Another noteworthy finding of our study is that there is no statistically significant difference betwen first and second generation antipsychotic use and TD prevalence. Sonuç: Uzun süreli ilaç kullanımı olan bir grupta %22.5 oranı, yine de, beklenenden düşüktür. Hastaların hastane ortamında ve sağlık çalışanları gözetiminde doğrudan ve yakın izlemde olmaları ve risk oluşturabilecek durumlara erken müdahale edilmesi bu durum için bir açıklama olabilir. 1. ve 2. kuşak antipsikotik kullanımıyla ile TD yaygınlığı arasında çalışmamızda istatistik olarak anlamlı fark bulunmamısı da bir diğer önemli bulgudur.

show abstract

“…The pathophysiology of TD remains elusive, though multiple hypotheses have been proposed (summarized in Table 1). Other than neuroleptic exposure, risk factors for developing TD include older age [13,14], African-American ethnicity [15,16], the presence of diabetes mellitus [17,18], and the occurrence of acute dystonic reactions or drug-indiced parkinsonism [19,20]. Female sex, prior brain damage, cocaine abuse, alcohol consumption, and a diagnosis of bipolar disorder are less consistently correlated with TD [2].…”

Section: Introductionmentioning

confidence: 99%

Tardive Dyskinesia: Therapeutic Options for an Increasingly Common Disorder

2014

View full text Add to dashboard Cite

Tardive dyskinesia (TD) is a serious, often disabling, movement disorder that is caused by medications that block dopamine receptors (i.e., neuroleptics, anti-emetics). There is currently no standard treatment approach for physicians confronted with such patients. This may be the result of notions that TD is disappearing because of the switch to secondgeneration antipsychotic agents and that it is largely reversible.In this article we demonstrate that second-generation antipsychotics do, indeed, cause TD and, in fact, the frequency is likely higher than expected because of growing off-label uses and a tripling of prescriptions written in the last 10 years. In addition, studies demonstrate that TD actually remits in only a minority of patients when these drugs are withdrawn. Furthermore, neuroleptic agents are often utilized to treat TD, despite prolonged exposure being a risk factor for irreversibility. The outcome of these trends is a growing population afflicted with TD. We review non-neuroleptic agents that have shown positive results in small, early-phase, blinded trials, including tetrabenazine, amantadine, levetiracetam, piracetam, clonazepam, propranolol, vitamin B6, and Ginkgo biloba. Other options, such as botulinum toxin and deep brain stimulation, will also be discussed, and a suggested treatment algorithm is provided. While these agents are reasonable treatment options at this time there is a need, with a concerted effort between neurology and psychiatry, for full-scale drug development, including multicenter, randomized, blinded trials to confirm the effectiveness of the agents that were positive in phase 2 trials and the development of newer ones.

show abstract

Ethnicity and the Course of Tardive Dyskinesia in Outpatients Presenting to the Motor Disorders Clinic at the Maryland Psychiatric Research Center

Abstract: Reports from earlier studies note ethnicity (African descent) as a risk factor in the development of TD. Our study findings suggest ethnicity might be an important factor in predicting a poor course of TD.

Cited by 42 publications

References 46 publications

The role of dopamine D3, 5-HT2A and 5-HT2C receptor variants as pharmacogenetic determinants in tardive dyskinesia in African-Caribbean patients under chronic antipsychotic treatment

The role of dopamine D3, 5-HT2A and 5-HT2C receptor variants as pharmacogenetic determinants in tardive dyskinesia in African-Caribbean patients under chronic antipsychotic treatment

Tardive dyskinesia in long term hospitalized patients with schizophrenia

Tardive Dyskinesia: Therapeutic Options for an Increasingly Common Disorder

Contact Info

Product

Resources

About