&lt;p&gt;Overcoming barriers to effective management of tardive dyskinesia&lt;/p&gt;

Caroff, Stanley N.

doi:10.2147/ndt.s196541

Cited by 27 publications

(39 citation statements)

References 96 publications

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“…Prevention remains the best strategy to treat TD. Screening tests and the frequency of their taking, the doses and duration of using the drug play a key role in the early diagnosis and thus the prevention of TD [10].…”

Section: Discussionmentioning

confidence: 99%

“…Rigorous trials have confirmed that both drugs are more effective than placebo in reducing the severity of TD and are better tolerated than tetrabenazine [9]. Caroff in his study showed that the use of valbenazine reduces the symptoms of TD, even 4 weeks after its discontinuation [10].…”

Section: Tetrabenazine Analogsmentioning

confidence: 99%

“…Rygorystyczne próby potwierdziły, że oba leki są bardziej skuteczne niż placebo w zmniejszaniu nasilenia TD i są lepiej tolerowane niż tetrabenazyna [9]. Caroff w swoim badaniu wykazał, że stosowanie walbenazyny wpływa na zmniejszenie objawów TD, nawet 4 tygodnie po jej odstawieniu [10].…”

Section: Analogi Tetrabenazynyunclassified

“…Wciąż najlepszą strategią walki z TD pozostaje profilaktyka. We wczesnym rozpoznaniu, a przez to zapobieganiu TD, kluczową rolę odgrywają badania przesiewowe, częstotliwość ich wykonywania, zastosowane dawki leku oraz czas jego przyjmowania [10].…”

Section: Dyskusjaunclassified

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Drug-induced dyskinesias, can they be prevented?

Романюк

Suswał

Skałecka

et al. 2020

Current Problems of Psychiatry

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Introduction: Dyskinesia is a symptom complex in the form of involuntary, repetitive movements of lips, lower jaw, tongue, less often the trunk and limbs. Despite the use of newer drugs in treatment neuroleptics, dyskinesia has not ceased to be a clinical problem.Method: The work is based on a research review for which the Google Scholar database was used as well PubMed. The search range was limited to 2008-2020. We have included descriptive publications tardive dyskinesia only as a consequence of antipsychotic medications.Material: We present the use of tetrabenazine analogues, deep brain stimulation, neuroleptics, benzodiazepines and botulinum toxin in late-suffering patients drug-induced dyskinesias, which may indicate an improvement in your health.Discussion: The first method of treating tardive dyskinesia are withdrawal antipsychotic medications, but for many patients this is impossible. Valbenazine and Deep Brain Stimulation are the most effective in treating Tardive Dyskinesia.Conclusions: There are not enough studies with the highest reliability to create unequivocal recommendations in the treatment of drug-induced tardive dyskinesia.

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Section: Discussionmentioning

confidence: 99%

Section: Tetrabenazine Analogsmentioning

confidence: 99%

Section: Analogi Tetrabenazynyunclassified

Section: Dyskusjaunclassified

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Drug-induced dyskinesias, can they be prevented?

Романюк

Suswał

Skałecka

et al. 2020

Current Problems of Psychiatry

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“…The importance of well-being during pharmacotherapy is receiving more and more attention [129] and is particularly relevant in explaining the high adherence of some patients to clozapine, demonstrated by the lower discontinuation rates in cohort studies [127,128]. Clozapine positive effects on well-being in some patients may be influenced by clozapine effects on extrapyramidal symptoms [130][131][132][133][134][135][136][137][138][139][140][141][142], hostility [143,144] and the "awakening" phenomenon [145][146][147] (online suppl. Box S5, section 3).…”

Section: Clozapine and Well-beingmentioning

confidence: 99%

A Rational Use of Clozapine Based on Adverse Drug Reactions, Pharmacokinetics, and Clinical Pharmacopsychology

Leon

Ruan

Schoretsanitis

et al. 2020

Psychother Psychosom

121

113

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Using Richardson and Davidson's model and the sciences of pharmacokinetics and clinical pharmacopsychology, this article reviewed the: (1) poor life expectancy associated with treatment-resistant schizophrenia (TRS), which may be improved in patients who adhere to clozapine; (2) findings that clozapine is the best treatment for TRS (according to efficacy, effectiveness and well-being); and (3) potential for clozapine to cause vulnerabilities, including potentially lethal adverse drug reactions such as agranulocytosis, pneumonia, and myocarditis. Rational use requires: (1) modification of the clozapine package insert worldwide to include lower doses for Asians and to avoid the lethality associated with pneumonia, (2) the use of clozapine levels for personalizing dosing, and (3) the use of slow and personalized titration. This may make clozapine as safe as possible and contribute to increased life expectancy and well-being. In the absence of data on COVID-19 in clozapine patients, clozapine possibly impairs immunological mechanisms and may increase pneumonia risk in infected patients. Psychiatrists should call their clozapine patients and families and explain to them that if the patient develops fever or flu-like symptoms, the psychiatrist should be called and should consider halving the clozapine dose. If the patient is hospitalized with pneumonia, the treating physician needs to assess for symptoms of clozapine intoxication since halving the dose may not be enough for all patients; consider decreasing it to one-third or even stopping it. Once the signs of inflammation and fever have disappeared, the clozapine dose can be slowly increased to the prior dosage level. 46, 48, 52-67] describes the important pharmacokinetic variables for clozapine clearance. Higher clozapine C/D ratios, indicating lower clearance, are associated with females, non-smokers, Asians, genetic poor metabolizers, inhibitors, obesity, inflammation, and possibly with renal impairment and pregnancy. Lower clozapine C/D ratios indicate lack of adherence or higher clearance associated with males, smokers, non-Asians, and inducers.Two prior TDM review articles [68,69] are summarized in online supplementary Box S3 [31, 44, 50, 51, 55, 58-61, 63, 65, 68-91] which also describe our extensive experience with thousands of inpatient clozapine TDMs under standard conditions (trough and steady-state levels) in the US [44] and China [45,65]. Many of these inpatients were followed for months and/or years after changes in important pharmacokinetic variables [31, 44, 50, 58-61, 63, 65, 74, 79, 86-91].Published review articles [92][93][94] usually insist on the wide variability of clozapine TDM among individuals and the difficulty of interpreting a single clozapine level, but they fail to pay attention to findings from these two sciences: pharmacokinetics and clinical pharmacopsychology, which help in interpreting variability in clozapine levels. In inpatients, repeated measures allow the calculation of average clozapine clearance in an individual through a...

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