Heterogeneity of Tardive Dyskinesia

1988 ◽  
Vol 152 (2) ◽  
pp. 253-259 ◽  
Author(s):  
William M. Glazer ◽  
Hal Morgenstern ◽  
Donna Niedzwiecki ◽  
Jeffrey Hughes
Keyword(s):  
Tardive Dyskinesia ◽  
Mental Health Center ◽  
Involuntary Movement ◽  
Living Alone ◽  
Psychiatric Medication ◽  
New Haven ◽  
Abnormal Movements ◽  
Clinical Syndromes ◽  
Severity Scores ◽  
Orofacial Movement

To determine whether tardive dyskinesia (TD) is a single abnormal movement syndrome or multiple syndromes involving different anatomical areas, we examined 228 out-patients diagnosed with TD at the Connecticut Mental Health Center in New Haven. Application of factor analysis to the seven anatomical severity scores of the Abnormal Involuntary Movement Scale yielded three statistically independent factors involving abnormal movements primarily of the jaw-tongue, face-lips, and extremities-trunk. Using logistic regression to predict the severity of these factors, we found that the severity of the orofacial scores was positively associated with age, schizoaffective or affective disorder, and living alone, while severity of non-orofacial movement was positively associated with current neuroleptic dose, non-use of psychiatric medication, and living alone. Our findings suggest that orofacial and non-orofacial dyskinetic movements may involve distinct clinical syndromes of TD, each having a different set of prognostic and, possibly, aetiological determinants.

Diazepam in Tardive Dyskinesia

1983 ◽  
Vol 17 (7-8) ◽  
pp. 523-527 ◽  
Author(s):  
Stanley S. Weber ◽  
Robert L. Dufresne ◽  
Robert E. Becker ◽  
Peter Mastrati
Keyword(s):  
Tardive Dyskinesia ◽  
Rating Scale ◽  
Case Reports ◽  
Involuntary Movement ◽  
Similar Degree ◽  
Brief Psychiatric Rating Scale ◽  
Abnormal Movements ◽  
Psychiatric Rating ◽  
Motor Movements ◽  
Psychiatric Rating Scale

Tardive dyskinesia, a syndrome of involuntary motor movements, can be a permanent consequence of the long-term use of antipsychotic drugs. While there is no well-established drug treatment, case reports and the results of a few clinical studies suggest that drugs that facilitate the GABA-ergic system may decrease the abnormal movements. One such class of drugs is the benzodiazepines. We administered diazepam to 13 subjects in a 24-week, crossover design study. Tardive dyskinesia and psychopathology were assessed by blind raters using the Abnormal Involuntary Movement Scale and the Brief Psychiatric Rating Scale (BPRS). The means of all movement measurements improved from the baseline, with orofacial, subtotal, symptom severity, and total reaching significance. However, we were unable to demonstrate a drug effect; the patients improved to a similar degree whether or not they received diazepam. Their psychiatric disorders did not worsen with diazepam administration and, in fact, improved slightly; the activation factor of the BPRS was significantly improved over baseline. Our results suggest that diazepam is not effective in managing the movements of tardive dyskinesia and that behavior modification strategies be investigated to help patients control symptoms.

Orofacial Dyskinesia, Cognitive Function and Medication

1986 ◽  
Vol 149 (2) ◽  
pp. 216-220 ◽  
Author(s):  
Philip Thomas ◽  
Ralph McGuire
Keyword(s):  
Regression Analysis ◽  
Cognitive Function ◽  
Tardive Dyskinesia ◽  
Involuntary Movement ◽  
The Other ◽  
Orofacial Dyskinesia ◽  
Duration Of Treatment ◽  
Delayed Recall ◽  
Abnormal Involuntary Movement Scale ◽  
Abnormal Movements

The presence of tardive dyskinesia in a sample of 43 patients with schizophrenia and 37 psychopaths who had been hospitalised for many years and exposed to large amounts of medication was assessed while testing their cognitive function. Subjects who showed no evidence of abnormal movements performed significantly better on the test of delayed recall, but there were no differences in performance on any of the other tests of cognitive function used. Multiple regression analysis revealed that age and the total lifetime dose of neuroleptic medication received (in chlorpromazine equivalents) were the only variables to predict the Abnormal Involuntary Movement Scale score, although a large amount of variance in this variable was unaccounted for. The duration of treatment with neuroleptics did not predict AIMS score.

scholarly journals Randomized controlled trial of deutetrabenazine for tardive dyskinesia

Neurology ◽  
2017 ◽  
Vol 88 (21) ◽  
pp. 2003-2010 ◽  
Author(s):  
Hubert H. Fernandez ◽  
Stewart A. Factor ◽  
Robert A. Hauser ◽  
Joohi Jimenez-Shahed ◽  
William G. Ondo ◽  
...  
Keyword(s):  
Tardive Dyskinesia ◽  
Primary Endpoint ◽  
Rating Scale ◽  
Involuntary Movement ◽  
Controlled Trial ◽  
Treatment Success ◽  
Eligibility Criteria ◽  
Double Blind ◽  
Abnormal Movements ◽  
Global Impression Of Change

Objective:To determine the efficacy and safety of deutetrabenazine as a treatment for tardive dyskinesia (TD).Methods:One hundred seventeen patients with moderate to severe TD received deutetrabenazine or placebo in this randomized, double-blind, multicenter trial. Eligibility criteria included an Abnormal Involuntary Movement Scale (AIMS) score of ≥6 assessed by blinded central video rating, stable psychiatric illness, and stable psychoactive medication treatment. Primary endpoint was the change in AIMS score from baseline to week 12. Secondary endpoints included treatment success at week 12 on the Clinical Global Impression of Change (CGIC) and Patient Global Impression of Change.Results:For the primary endpoint, deutetrabenazine significantly reduced AIMS scores from baseline to week 12 vs placebo (least-squares mean [standard error] −3.0 [0.45] vs −1.6 [0.46],p= 0.019). Treatment success on CGIC (48.2% vs 40.4%) favored deutetrabenazine but was not significant. Deutetrabenazine and placebo groups showed low rates of psychiatric adverse events: anxiety (3.4% vs 6.8%), depressed mood/depression (1.7% vs 1.7%), and suicidal ideation (0% vs 1.7%, respectively). In addition, no worsening in parkinsonism, as measured by the Unified Parkinson's Disease Rating Scale motor subscale, was noted from baseline to week 12 in either group.Conclusions:In patients with TD, deutetrabenazine was well tolerated and significantly reduced abnormal movements.Classification of evidence:This study provides Class I evidence that in patients with TD, deutetrabenazine reduces AIMS scores.

Pharmacy-Based Screening Program for Tardive Dyskinesia

1988 ◽  
Vol 22 (3) ◽  
pp. 205-208 ◽  
Author(s):  
Thomas N. Ahrens ◽  
John J. Sramek ◽  
John M. Herrera ◽  
Christina M. Jewett ◽  
Velma E. Alcorn
Keyword(s):  
Tardive Dyskinesia ◽  
Older Patients ◽  
Screening Program ◽  
Psychiatric Patients ◽  
Involuntary Movement ◽  
Masking Effect ◽  
Prevalence Survey ◽  
Abnormal Movements ◽  
Rating Method ◽  
Higher Doses

An ongoing screening program using pharmacists to detect tardive dyskinesia (TD) was developed, and a pharmacy-based prevalence survey of TD in chronic hospitalized psychiatric patients was undertaken to determine the extent of abnormal involuntary movements. The results show that older patients and women in particular are at higher risk for developing abnormal movements. Higher doses of neuroleptics were used in non-TD patients, indicating a possible masking effect caused by these drugs. By using a standardized rating method such as the Abnormal Involuntary Movement Scale, pharmacists can and should be utilized in the surveillance of TD.

Treatment of tardive dyskinesia

1978 ◽  
Vol 16 (14) ◽  
pp. 55-56
Keyword(s):  
Tardive Dyskinesia ◽  
Late Onset ◽  
Psychiatric Patients ◽  
Term Treatment ◽  
Neuroleptic Drugs ◽  
Abnormal Movements ◽  
Long Term Treatment ◽  
The Face ◽  
Schizophrenic Patients

Neuroleptic drugs cause many forms of extra-pyramidal syndromes. One of these, tardive dyskinesia,1 occurs only after the patient has been taking the drug for some time (‘tardive’ refers to the late onset). The movements are involuntary and repetitive usually involving the face and tongue, but they may also affect the limbs and trunk. Tongue protrusion, licking and smacking of the lips, sucking and chewing movements, grimacing, grunting, blinking and furrowing of the forehead have all been described and attributed to long-continued medication with neuroleptic drugs of the phenothiazine, butyrophenone and thioxanthene groups. The patient can inhibit the movements, but anxiety makes them worse. Many of these symptoms were noticed in schizophrenic patients before neuroleptic drugs were introduced2 and they can occur in otherwise normal untreated elderly people. Nevertheless it is generally accepted that in most cases tardive dyskinesia is an unwanted effect of neuroleptic medication. Despite suggestions to the contrary, the abnormal movements are not necessarily associated with high dosage of neuroleptic drugs or with pre-existing brain damage.3 4 Tardive dyskinesia has been reported in 3–6% of a mixed population of psychiatric patients5 and over half of a group of chronic schizophrenics on long-term treatment.4 The more careful the neurological examination, the greater the apparent incidence.

scholarly journals 149 Deutetrabenazine for the Treatment of Tardive Dyskinesia: Results From an Open-Label, Long-Term Study

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 92-93
Author(s):  
Karen E. Anderson ◽  
Mat D. Davis ◽  
Stewart A. Factor ◽  
Robert A. Hauser ◽  
L. Fredrik Jarskog ◽  
...  
Keyword(s):  
Tardive Dyskinesia ◽  
Involuntary Movement ◽  
Treatment Success ◽  
Open Label ◽  
Dopamine Receptor Antagonists ◽  
Long Term Study ◽  
Patient Global Impression ◽  
Pharmaceutical Industries ◽  
Global Impression Of Change

AbstractIntroductionTardive dyskinesia (TD) is an involuntary movement disorder resulting from exposure to dopamine-receptor antagonists. In the 12-week ARM-TD and AIM-TD studies, deutetrabenazine demonstrated significant improvements in Abnormal Involuntary Movement Scale (AIMS) scores at Week 12 compared with placebo, and was generally well tolerated.ObjectiveTo evaluate the efficacy and safety of long-term deutetrabenazine therapy in patients with TD.MethodsPatients with TD who completed the ARM-TD or AIM-TD studies were eligible to enter this open-label, single-arm, long-term safety study after they completed the 1-week washout period and final evaluation in the blinded portion of the trial. Efficacy endpoints included the change in AIMS score from baseline, and treatment success (defined as “much improved” or “very much improved”) on the Clinical Global Impression of Change (CGIC) and Patient Global Impression of Change (PGIC). This analysis reports results up to Week 54.Results304 patients enrolled in the extension study. At Week 54, the mean (standard error) change in AIMS score was –5.1 (0.52). After 6 weeks of deutetrabenazine treatment, the proportion of patients who achieved treatment success was 58% per the CGIC and 53% per the PGIC, and by Week 54 was 72% per the CGIC and 59% per the PGIC, thus demonstrating maintenance or enhancement of benefit over time. Deutetrabenazine was well tolerated for up to 54 weeks, and compared with the ARM-TD and AIM-TD studies, no new safety signals were detected.Conclusions54 weeks of deutetrabenazine treatment was generally efficacious, safe, and well tolerated in patients with TD.Presented at: The American Psychiatric Association 2017 Annual Meeting; May 20–24, 2017; San Diego, California, USA.Funding AcknowledgementsThis study was funded by Teva Pharmaceutical Industries, Petach Tikva, Israel.

scholarly journals 116 An Experimental Study to Assess the Professional and Social Consequences of Tardive Dyskinesia

CNS Spectrums ◽  
2020 ◽  
Vol 25 (2) ◽  
pp. 275-276 ◽  
Author(s):  
Rajeev Ayyagari ◽  
Debbie Goldschmidt ◽  
Fan Mu ◽  
Stanley N. Caroff ◽  
Benjamin Carroll
Keyword(s):  
Tardive Dyskinesia ◽  
Involuntary Movement ◽  
Population Sample ◽  
Group Versus ◽  
Test Group ◽  
Categorical Variables ◽  
Control Group ◽  
Study Objective ◽  
Social Lives ◽  
The Impact

Abstract:Study Objective:Evaluate the impact of orofacial tardive dyskinesia (TD) symptoms on the professional and social lives of patients with TD.Background:TD, a movement disorder affecting the face and extremities, may arise in patients taking antipsychotics. The impact of social stigma on the professional and social lives of patients with orofacial manifestations of TD has not been thoroughly examined.Methods:This study is an experimental, randomized digital survey of a general population sample. Three component surveys were developed, corresponding to employment, dating, and friendship domains. For each domain, participants were randomized 1:1 into either a test group (who viewed a video of a scripted interview with a standardized patient actor depicting TD movements) or a control group (who viewed the same actors but without TD movements), and asked about their impressions of the video subject. Actor simulations were validated by physicians familiar with TD and rehearsed to simulate a total Abnormal Involuntary Movement Scale score between 6 and 10. Statistical comparison was made using Wilcoxon sign-rank or chi-squared tests for continuous and categorical variables, respectively.Results:A total of 800 respondents completed each survey. In all domains, respondents had more-negative perceptions of actors portraying TD movements than of the same actors without movements. Regarding employment, 34.8% fewer respondents in the test group versus the control group agreed that the actor would be suitable for client-facing jobs (P<0.001). Regarding dating, the proportions of respondents who agreed that they would like to continue talking to the actor and who would be interested in meeting them for coffee/drink were 25.0% and 27.2% lower, respectively, in the test group than in the control group (P<0.001). Regarding friendship, the proportions of respondents who rated the actor as interesting and who would be interested in friendship with them were 18.8% and 16.5% lower, respectively, in the test group than in the control group (P<0.001).Conclusions:Actors simulating orofacial TD movements were perceived to be statistically significantly less likely to move forward in a job interview, be considered as a potential romantic partner, or be a new friend. This is the first study to quantify the stigma faced by people with TD in a variety of professional and social situations.Funding Acknowledgements:This study was funded by Teva Pharmaceuticals, Petach Tikva, Israel.

scholarly journals 134 Improvements in Clinical Global Impression of Change With Deutetrabenazine Treatment in Tardive Dyskinesia From the ARM-TD and AIM-TD Studies

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 84-84
Author(s):  
Hubert H. Fernandez ◽  
Mat D. Davis ◽  
Stewart A. Factor ◽  
Robert A. Hauser ◽  
L. Fredrik Jarskog ◽  
...  
Keyword(s):  
Tardive Dyskinesia ◽  
Clinical Global Impression ◽  
Involuntary Movement ◽  
Treatment Success ◽  
Body Region ◽  
Double Blind ◽  
Categorical Analysis ◽  
Pharmaceutical Industries ◽  
Clinically Significant ◽  
Global Impression Of Change

AbstractIntroductionTardive dyskinesia (TD) is an involuntary movement disorder that is often irreversible, can affect any body region, and can be debilitating. In the ARM-TDand AIM-TD studies, deutetrabenazine treatment demonstrated statistically and clinically significant reductions in Abnormal Involuntary Movement Scale (AIMS) scores at Week 12 compared with placebo (primary endpoint).ObjectiveTo evaluate the efficacy of deutetrabenazine, as measured by the Clinical Global Impression of Change (CGIC) scale, in patients with TD from the pooled ARM-TDand AIM-TD (24 and 36 mg/day doses) data sets, as compared with the pooled placebo cohort.MethodsARM-TD and AIM-TD were 12-week, randomized, double-blind, placebo-controlled studies that evaluated the safety and efficacy of deutetrabenazine for thetreatment of TD. The key secondary endpoint of each study was the proportion of patients “much improved” or “very much improved” (treatment success) at Week 12 on theCGIC.ResultsAt Week 12, the odds of treatment success among patients treated with deutetrabenazine (n=152) was more than double that of patients given placebo (n=107; odds ratio: 2.12; P=0.005). In a categorical analysis of CGIC ratings, patients treated with deutetrabenazine showed greater improvement than patients given placebo (P=0.003). Patients treated with deutetrabenazine also had a significantly better treatment response than those given placebo (least-squares mean CGIC score treatment difference: –0.4; P=0.006).ConclusionsDeutetrabenazine treatment led to statistically and clinically significant improvements in TD symptoms based on the CGIC result, suggesting that clinicians were able to recognize the benefit in patients treated with deutetrabenazine.Presented at: The International Congress of Parkinson’s Disease and Movement Disorders; June 4–8, 2017; Vancouver, British Columbia, Canada.Funding AcknowledgementsThese studies were funded by Teva Pharmaceutical Industries, Petach Tikva, Israel.

Assessment of Tardive Dyskinesia in Psychiatric Outpatients Using a Standardized Rating Scale

1981 ◽  
Vol 15 (1) ◽  
pp. 33-37 ◽  
Author(s):  
J. M. Rey ◽  
G. E. Hunt ◽  
G. F. S. Johnson
Keyword(s):  
Tardive Dyskinesia ◽  
Neurological Disorders ◽  
Rating Scale ◽  
Involuntary Movement ◽  
Antidepressant Medication ◽  
Tricyclic Antidepressant ◽  
Neuroleptic Treatment ◽  
Psychiatric Outpatients ◽  
History Of ◽  
Australian Sample

Psychiatric outpatients were assessed for dyskinetic movements using the abnormal involuntary movement scale (AIMS). The prevalance of tardive dyskinesia in an Australian sample of 66 patients was 44% which is similar to reported prevalence in other countries. Although the prevalence was significantly higher in patients over 45 years of age and with more than a 5 year history of neuroleptic medication, there were no significant correlations between presence of dyskinesias and age, sex or duration of neuroleptic treatment. Organic factors such as neurological disorders, ECT or alcoholism were not related to dyskinetic movements, nor was the use of anticholinergic or tricyclic antidepressant medication. The AIMS is a reliable rating scale for dyskinetic movements and could be used more widely as a screening instrument for early detection of tardive dyskinesia.

Sign in / Sign up

Export Citation Format

Share Document