Ten-year outcome of tardive dyskinesia

Gárdos, George; De, Casey; Jo, Cole; Perenyi, Andras; Kocsis, Edit; Arató, M.; Ja, Samson; Conley, Caitlyn

doi:10.1176/ajp.151.6.836

Cited by 61 publications

(4 citation statements)

References 18 publications

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“…Another limitation was the high rate of discontinuations, which resulted in relatively short duration of treatment and follow-up; length of follow-up has been associated with increasing rates of stabilization and improvement of TD. 1,10 Nevertheless, the duration of treatment was comparable to those in prior studies of second-generation antipsychotics; for example, the average duration of the trials referenced in the review by Correll et al 53 was only 8.8 months. Finally, there were no attempts at dose reduction or withdrawal in the trial, so we cannot say whether decreases in AIMS scores represented reversal or suppression of TD symptoms.…”

Section: Discussionmentioning

confidence: 64%

“…Data on the change in prevalence of TD during treatment have been inconclusive, with some studies showing an increase 3–6 and others, a decrease 7–9 or no change at all. 10,11 However, prevalence rates as well as mean dyskinesia scores obscure the dynamics of TD in individual patients. Although estimates have varied, 1,12–15 roughly 50% of patients have persistent TD symptoms, 10% to 30% have a reduction in symptoms, and 10% to 30% show increased symptoms during treatment.…”

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confidence: 99%

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Treatment Outcomes of Patients With Tardive Dyskinesia and Chronic Schizophrenia

Caroff¹,

Davis²,

Miller³

et al. 2010

J. Clin. Psychiatry

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Objective We compared the response to antipsychotic treatment between patients with and without tardive dyskinesia (TD) and examined the course of TD. Method This analysis compared 200 patients with DSM-IV–defined schizophrenia and TD and 997 patients without TD, all of whom were randomly assigned to receive one of 4 second-generation antipsychotics. The primary clinical outcome measure was time to all-cause treatment discontinuation, and the primary measure for evaluating the course of TD was change from baseline in Abnormal Involuntary Movement Scale (AIMS) score. Kaplan-Meier survival analysis and Cox proportional hazards regression models were used to compare treatment discontinuation between groups. Changes in Positive and Negative Syndrome Scale (PANSS) and neurocognitive scores were compared using mixed models and analysis of variance. Treatment differences between drugs in AIMS scores and all-cause discontinuation were examined for those with TD at baseline. Percentages of patients meeting criteria for TD postbase-line or showing changes in AIMS scores were evaluated with χ2 tests. Data were collected from January 2001 to December 2004. Results Time to treatment discontinuation for any cause was not significantly different between the TD and non-TD groups (χ21 =0.11, P = .743). Changes in PANSS scores were not significantly different (F1,974 = 0.82, P = .366), but patients with TD showed less improvement in neurocognitive scores (F1,359=6.53, P =.011). Among patients with TD, there were no significant differences between drugs in the decline in AIMS scores (F3,151 = 0.32, P = .811); 55% met criteria for TD at 2 consecutive visits postbaseline, 76% met criteria for TD at some or all postbaseline visits, 24% did not meet criteria for TD at any subsequent visit, 32% showed a ≥ 50% decrease in AIMS score, and 7% showed a ≥ 50% increase in AIMS score. Conclusions Schizophrenia patients with and without TD were similar in time to discontinuation of treatment for any cause and improvement in psychopathology, but differed in neurocognitive response. There were no significant differences between treatments in the course of TD, with most patients showing either persistence of or fluctuation in observable symptoms. Trial Registration clinicaltrials.gov Identifier: NCT00014001

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Section: Discussionmentioning

confidence: 64%

mentioning

confidence: 99%

Treatment Outcomes of Patients With Tardive Dyskinesia and Chronic Schizophrenia

Caroff¹,

Davis²,

Miller³

et al. 2010

J. Clin. Psychiatry

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“…For example, in a prospective study of 99 of 182 patients available for reassessment after a 3- year-follow-up, the point prevalence of oro-facial dyskinesia increased from 39% to 47% [ 11 ]. In a 10-year follow-up study in Hungary, 66 out of 122 patients with TD received 5- and 10-year follow-up assessments, and the overall prevalence of TD changed little over time, with 30.2% at baseline, 36.5% at 5 years, and 31.7% at 10 years [ 12 ]. Another 10-year follow-up study of 10 patients with TD receiving FGA treatment showed an equal likelihood for improvement as for deterioration, while progressive worsening to severe forms of TD was not observed [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

The Outcome of Antipsychotics-induced Tardive Syndromes: A Ten-year Follow-up Study

Chou

Lee

Chang

et al. 2023

Clin Psychopharmacol Neurosci

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Objective Tardive syndrome (TS) is an umbrella term used to describe a group of abnormal movement disorders caused by chronic exposure to dopamine receptor blocking agents. Few follow-up studies have been performed on the outcome of TS in patients using antipsychotics. The purpose of our study was to investigate the prevalence, incidence, remission rate, and factors associated with remission in patients using antipsychotics. Methods This retrospective cohort study consisted of 123 patients who received continuous treatment of antipsychotics in a medical center in Taiwan, from April 1, 2011 to May 31, 2021. We assessed the demographic and clinical characteristics, prevalence, incidence, remission rate, and factors associated with remission in patients using antipsychotics. TS remission was defined as a Visual Analogue Scale score ≤ 3. Results Of the 92 patients who completed the 10-year follow-up, 39 (42.4%) were found to have at least one episode of TS, with tardive dyskinesia (TD) being the most prevalent subtype (51.3%). With regard to concurrent physical illness, a history of extrapyramidal symptoms were significant risk factors for TS. During the 10-year follow-up period, the remission rate of TS was 74.3%. The use of antioxidants including vitamin B6 and piracetam was related to the remission of TS. Patients with tardive dystonia had a higher remission rate (87.5%) compared to TD (70%). Conclusion Our study suggests that TS may be a treatable condition, and the key to a better outcome is early detection and prompt intervention, including closely monitoring antipsychotics-related TS symptoms and using antioxidants.

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“…Tardive dyskinesia (TD) is a movement disorder that rarely remits 3 and poses significant social stigma and physical discomfort for the patient. It occurs following the initiation, administration or withdrawal of a dopaminergic antagonist or indirect dopaminergic inhibitor such as a selective serotonergic reuptake inhibitor.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of pharmacogenomic studies in tardive dyskinesia associated with patients with psychiatric disorders

Chang

Fung

2014

PGPM

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Pharmacogenomics is the study of the effects of genetic polymorphisms on medication pharmacokinetics and pharmacodynamics. It offers advantages in predicting drug efficacy and/or toxicity and has already changed clinical practice in many fields of medicine. Tardive dyskinesia (TD) is a movement disorder that rarely remits and poses significant social stigma and physical discomfort for the patient. Pharmacokinetic studies show an association between cytochrome P450 enzyme-determined poor metabolizer status and elevated serum antipsychotic and metabolite levels. However, few prospective studies have shown this to correlate with the occurrence of TD. Many retrospective, case-control and cross-sectional studies have examined the association of cytochrome P450 enzyme, dopamine (receptor, metabolizer and transporter), serotonin (receptor and transporter), and oxidative stress enzyme gene polymorphisms with the occurrence and severity of TD. These studies have produced conflicting and confusing results secondary to heterogeneous inclusion criteria and other patient characteristics that also act as confounding factors. This paper aims to review and summarize the pharmacogenetic findings in antipsychotic-associated TD and assess its clinical significance for psychiatry patients. In addition, we hope to provide insight into areas that need further research.

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Ten-year outcome of tardive dyskinesia

Abstract: The data of this 10-year follow-up study provide evidence for the long-term stability of tardive dyskinesia and for the feasibility of maintenance neuroleptic therapy for chronic psychotic patients who have tardive dyskinesia.

Cited by 61 publications

References 18 publications

Treatment Outcomes of Patients With Tardive Dyskinesia and Chronic Schizophrenia

Treatment Outcomes of Patients With Tardive Dyskinesia and Chronic Schizophrenia

The Outcome of Antipsychotics-induced Tardive Syndromes: A Ten-year Follow-up Study

Clinical significance of pharmacogenomic studies in tardive dyskinesia associated with patients with psychiatric disorders

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