Tardive dyskinesia in children treated with atypical antipsychotic medications

Wonodi, Ikwunga; Reeves, Gloria; Carmichael, Dana; Verovsky, Ilene; Avila, Matthew T.; Elliott, Amie; Hong, L. Elliot; Adami, Helene; Thaker, Gunvant K.

doi:10.1002/mds.21618

Cited by 44 publications

(20 citation statements)

References 31 publications

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“…Moreover, two studies restricted the definition of APP to either a combination of risperidone with another antipsychotic (Simeon et al 2002), or to a combination of FGA+SGA (Wonodi et al 2007). …”

Section: Resultsmentioning

confidence: 99%

Prevalence and correlates of antipsychotic polypharmacy in children and adolescents receiving antipsychotic treatment

Toteja

Gallego

Saito

et al. 2013

Int. J. Neuropsychopharm.

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Antipsychotic polypharmacy (APP), which is common in adults with psychotic disorders, is of unproven efficacy and raises safety concerns. Although youth are increasingly prescribed antipsychotics, little is known about APP in this population. We performed a systematic PubMed search (last update 26 January 2013) of studies reporting the prevalence of APP in antipsychotic-treated youth. Summary statistics and statistical tests were calculated at the study level and not weighted by sample size. Fifteen studies (n=58 041, range 68–23 183) reported on APP in youth [mean age=13.4±1.7 yr, 67.1±10.2% male, 77.9±27.4% treated with second-generation antipsychotics (SGAs)]. Data collected in these studies covered 1993–2008. The most common diagnoses were attention-deficit hyperactivity disorder (ADHD; 39.9±23.5%) and conduct disorder/oppositional defiant disorder (CD/ODD; 33.6±24.8). In studies including predominantly children (mean age=<13 yr, N=5), the most common diagnosis were ADHD (50.6±25.4%) and CD/ODD (39.5±27.5%); while in studies with predominantly adolescents (mean age =≥13 yr, N=7) the most common diagnoses were schizophrenia-spectrum disorders (28.6±23.8%), anxiety disorders (26.9±14.9%) and bipolar-spectrum disorders (26.6±7.0%), followed closely by CD/ODD (25.8±17.7). The prevalence of APP among antipsychotic-treated youth was 9.6±7.2% (5.9±4.5% in child studies, 12.0±7.9% in adolescent studies, p=0.15). Higher prevalence of APP was correlated with a bipolar disorder or schizophrenia diagnosis (p=0.019) and APP involving SGA+SGA combinations (p=0.0027). No correlation was found with APP definition [≥1 d (N=10) vs. >30–≥90 d (N=5), p=0.88]. Despite lacking safety and efficacy data, APP in youth is not uncommon, even in samples predominantly consisting of non-psychotic patients. The duration, clinical motivations and effectiveness of this practice require further study.

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Section: Resultsmentioning

confidence: 99%

Prevalence and correlates of antipsychotic polypharmacy in children and adolescents receiving antipsychotic treatment

Toteja

Gallego

Saito

et al. 2013

Int. J. Neuropsychopharm.

View full text Add to dashboard Cite

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“…The relatively low rate of tardive dyskinesia in this analysis may be explained by the low medication doses used in the included studies. Wonodi et al (2007) evaluated children receiving antipsychotic drugs for 6 months or longer for tardive dyskinesia in comparison with a group of children who were antipsychotic naive. Eleven of 118 antipsychotic treated children exhibited tardive dyskinesia in comparison with none of 80 antipsychotic naive patients ( p ¼ 0.003).…”

Section: Discussionmentioning

confidence: 99%

Missed Diagnosis of Tardive Dystonia in an Adolescent Girl Treated with Risperidone

Pringsheim

2011

Journal of Child and Adolescent Psychopharmacology

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“…In addition, although SGAs are supposedly low in extrapyramidal side effects, 430 children in foster care in the state of Texas in 2004 “were prescribed antidyskinetics drugs to control side effects from antipsychotics” (Strayhorn, 2006, p. 77). The academic literature (Wonodi et al, 2007) adds concern with a finding of a 6% rate of tardive dyskinesia in a cohort of 5- to 18-year-olds on SGAs for over 6 months. Zito et al (2008) have drawn further academic attention to the harms of polypharmacy for Texas foster children.…”

Section: Iatrogenic Disaster?mentioning

confidence: 99%

Pediatric Bipolar Disorder in an Era of “Mindless Psychiatry”

Parry

Levin

2012

Journal of Trauma & Dissociation

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ObjectivePediatric bipolar disorder (PBD) reflects shifts in conceptualizing bipolar disorder among children and adolescents since the mid-1990s. Since then, PBD diagnoses, predominantly in the United States, have increased dramatically, and the diagnosis has attracted significant controversy. During the same period, psychiatric theory and practice has become increasingly biological. The aim of this paper is to examine the rise of PBD in terms of wider systemic influences.MethodIn the context of literature referring to paradigm shifts in psychiatry, we reviewed the psychiatric literature, media cases, and information made available by investigative committees and journalists.ResultsSocial historians and prominent psychiatrists describe a paradigm shift in psychiatry over recent decades: from an era of “brainless psychiatry,” when an emphasis on psychodynamic and family factors predominated to the exclusion of biological factors, to a current era of “mindless psychiatry” that emphasizes neurobiological explanations for emotional and behavioral problems with limited regard for contextual meaning. Associated with this has been a tendency within psychiatry and society to neglect trauma and attachment insecurity as etiological factors; the “atheoretical” (but by default biomedical) premise of the Diagnostic and Statistical Manual of Mental Disorders (3rd and 4th eds.); the influence of the pharmaceutical industry in research, continuing medical education, and direct-to-consumer advertising; and inequality in the U.S. health system that favors “diagnostic upcoding.” Harm from overmedicating children is now a cause of public concern.ConclusionIt can be argued that PBD as a widespread diagnosis, particularly in the United States, reflects multiple factors associated with a paradigm shift within psychiatry rather than recognition of a previously overlooked common disorder.

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Tardive dyskinesia in children treated with atypical antipsychotic medications

Cited by 44 publications

References 31 publications

Prevalence and correlates of antipsychotic polypharmacy in children and adolescents receiving antipsychotic treatment

Prevalence and correlates of antipsychotic polypharmacy in children and adolescents receiving antipsychotic treatment

Missed Diagnosis of Tardive Dystonia in an Adolescent Girl Treated with Risperidone

Pediatric Bipolar Disorder in an Era of “Mindless Psychiatry”

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