Tardive Syndromes are Rarely Reversible after Discontinuing Dopamine Receptor Blocking Agents: Experience from a University-based Movement Disorder Clinic

Zutshi, Deepti; Cloud, Leslie J.; Factor, Stewart A.

doi:10.7916/d8ms3r8c

Cited by 34 publications

(2 citation statements)

References 25 publications

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“…132 In a meta-analysis, Soares and McGrath reported that 37.3% of patients assigned to placebo across studies showed some improvement of TD, but concluded that evidence was insufficient to support antipsychotic drug cessation or dose reduction in view of the risk for psychotic relapse. 133 While recent surveys suggest as few as 2% to 5% of patients show resolution of TD without specific treatment even when followed-up for a few years after antipsychotic withdrawal, 134,135 earlier studies reported remission a few months to years after drug cessation in 50% to 75% of patients provided that TD was detected early. 83,[136][137][138] These early reports suggest that further studies of antipsychotic cessation in nonpsychotic patients as a management option for newonset cases of TD are needed.…”

Section: Formulating Individualized Treatment Plans For Patients With...mentioning

confidence: 99%

A new era in the diagnosis and treatment of tardive dyskinesia

Caroff

2022

CNS Spectr.

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Tardive dyskinesia (TD) is a heterogeneous, hyperkinetic movement disorder induced by dopamine-receptor blocking agents that presents a unique challenge in the treatment of psychosis. Although acceptance of TD as a serious consequence of antipsychotic treatment was resisted initially, subsequent research by many investigators in psychopharmacology contributed to a rich store of knowledge on many aspects of the disorder. While basic neuroscience investigations continue to deepen our understanding of underlying motor circuitry, past trials of potential treatments of TD focusing on a range of theoretical targets were often inconclusive. Development of newer antipsychotics promised to reduce the risk of TD compared to older drugs, but their improved tolerability unexpectedly enabled an expanding market that paradoxically both increased the absolute number of patients at risk and diminished attention to TD which was relegated to legacy status. Fortunately, development and approval of novel vesicular monoamine transporter inhibitors offered evidence-based symptomatic treatment of TD for the first time and rekindled interest in the disorder. Despite recent progress, many questions remain for future research including the mechanisms underlying TD, genetic predisposition, phenomenological diversity, whether new cases are reversible, how to implement best practices to prevent and treat TD, and whether the development of novel antipsychotics free of the risk of TD is attainable. We owe our patients the aspirational goal of striving for zero prevalence of persistent symptoms of TD in anyone treated for psychosis.

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Section: Formulating Individualized Treatment Plans For Patients With...mentioning

confidence: 99%

A new era in the diagnosis and treatment of tardive dyskinesia

Caroff

2022

CNS Spectr.

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“…Prevention of TD is important, as it may become chronic or irreversible in up to 50% of patients. 15 , 16 , 105 , 106 However, if detected early, it may be possible to halt the progress of TD in some patients by discontinuation or dose reduction of antipsychotics. 105 The risk of TD may also be reduced if alternative treatments are chosen when early dyskinesia is identified.…”

Section: Clinical Situation In Japanmentioning

confidence: 99%

Current perspectives on the epidemiology and burden of tardive dyskinesia: a focused review of the clinical situation in Japan

Mori

Takeuchi

Tsutsumi

2022

Therapeutic Advances in Psychopharmacology

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Tardive dyskinesia (TD) is a movement disorder that can develop with the use of dopamine receptor-blocking agents and is most commonly caused by antipsychotics. The use of antipsychotics is expanding, which may lead to an increased number of patients experiencing TD. To summarise the current knowledge of the epidemiology and risk factors for TD in Japan, we reviewed articles related to the current state of knowledge around TD identified through a PubMed search, and held a roundtable discussion of experts in Japan on 9 September 2021 to form the basis of the opinion presented within this review. The true prevalence of TD among patients treated with antipsychotics is not well characterised; it is reported to be between 15% and 50% globally and between 6.5% and 7.7% in Japan. Potential barriers to timely treatment of TD include the stigma surrounding mental health issues and the lack of data regarding TD in Asian patients. This review summarises the current knowledge of the epidemiology, challenges to TD diagnosis and risk factors for TD in Japan. Recent strategies for symptom monitoring and early diagnosis, as well as consensus recommendations are included. Achieving a high level of awareness of TD among physicians who treat patients with psychiatric disorders is of great importance and physicians should ensure that patients with psychiatric disorders receiving antipsychotics are proactively monitored for signs of TD. Plain Language Summary Plain Language Summary ( In Japanese ) Visual Summary Visual Summary ( In Japanese )

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Lurasidone‐Induced Tardive Syndrome

Tripathi

Reich

Scorr

et al. 2019

Movement Disord Clin Pract

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Introduction Tardive syndrome (TS) is an often irreversible movement disorder caused by dopamine receptor‐blocking agents (DRBAs). Although TS are well recognized to occur with typical antipsychotics, less well appreciated is that atypical antipsychotics also carry a risk of TS. Methods Case series. Results We describe 4 patients who developed tardive dystonia, tardive akathisia, and drug‐induced parkinsonism with the use of the atypical antipsychotic, lurasidone, which was U.S. Food and Drug Administration approved in 2013 for use in bipolar disorder and schizophrenia. Conclusion Movement disorders are reported as a rare side effect of lurasidone, and, as such, prescribers may perceive a false sense of security regarding this potential complication. Our cases indicate that this relatively new atypical antipsychotic may cause irreversible disabling TS as well as parkinsonism. Caution must be taken when prescribing lurasidone.

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Tardive Syndromes are Rarely Reversible after Discontinuing Dopamine Receptor Blocking Agents: Experience from a University-based Movement Disorder Clinic

Cited by 34 publications

References 25 publications

A new era in the diagnosis and treatment of tardive dyskinesia

A new era in the diagnosis and treatment of tardive dyskinesia

Current perspectives on the epidemiology and burden of tardive dyskinesia: a focused review of the clinical situation in Japan

Lurasidone‐Induced Tardive Syndrome

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