The Psychological Consequences of Tardive Dyskinesia the Effect of Drug-Induced Parkinsonism and the Topography of the Dyskinetic Movements

1991 ◽  
Vol 159 (3) ◽  
pp. 399-403 ◽  
Author(s):  
Keith W. Brown ◽  
Thomas White
Keyword(s):  
Cognitive Impairment ◽  
Tardive Dyskinesia ◽  
Negative Symptoms ◽  
Anticholinergic Medication ◽  
Psychological Consequences ◽  
Confounding Variable ◽  
Drug Induced

The effect of drug-induced Parkinsonism and of the topography of the dyskinetic movements on the psychological consequences of tardive dyskinesia was assessed in 20 schizophrenic subjects and 20 non-dyskinetic schizophrenic controls matched for age, sex, the presence of anticholinergic medication, and the presence and severity of drug-induced Parkinsonism. Limb–truncal subscale scores but not orofacial scores had a significant correlation with cognitive impairment and with negative symptoms. Drug-induced Parkinsonism was found to be a powerful confounding variable.

Sub-syndromes of tardive dyskinesia and some clinical correlates

1992 ◽  
Vol 22 (4) ◽  
pp. 923-927 ◽  
Author(s):  
K. W. Brown ◽  
T. White
Keyword(s):  
Cognitive Impairment ◽  
Tardive Dyskinesia ◽  
Movement Disorder ◽  
Principal Components Analysis ◽  
Principal Components ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Clinical Correlates ◽  
Facial Movements ◽  
Components Analysis

SynopsisSyndromes of dyskinetic movements in subjects (N = 70) with chronic schizophrenia were investigated, using principal components analysis of AIMS ratings. Consonant with previous research, three discrete groupings were found, namely dyskinetic movements of lips-jaw-tongue, limb-truncal and facial movements. These were then related to demographic, psychological and movement disorder variables. The limb-truncal, but neither the lips-jaw-tongue nor facial movements components, were associated with negative symptoms and cognitive impairment.

The Nature and Prevalence of Depression in Chronic Schizophrenic In-patients

1989 ◽  
Vol 154 (4) ◽  
pp. 486-491 ◽  
Author(s):  
Thomas R. E. Barnes ◽  
David A. Curson ◽  
Peter F. Liddle ◽  
Meena Patel
Keyword(s):  
Tardive Dyskinesia ◽  
Depressed Mood ◽  
Negative Symptoms ◽  
Auditory Hallucinations ◽  
Anticholinergic Medication ◽  
Chronic Schizophrenic ◽  
Depressed Group ◽  
Prevalence Of Depression ◽  
Suicidal Ideas

Out of 194 chronic schizophrenic inpatients, depressed mood (item 23 of the PSE) was present in 25 (13%). When compared with 25 matched controls, the patients with depressed mood had significantly higher scores on the MADRS and the Beck Depression Inventory. Serious suicidal ideas and auditory hallucinations were significantly more common in the depressed group. However, there were no significant differences between the matched groups in terms of negative symptoms, Parkinsonism, tardive dyskinesia, anticholinergic medication, or current dose of antipsychotic drug, which suggests that the depression identified was not related to drug treatment, nor was it a direct manifestation or misinterpretation of negative symptoms. Over three-month follow-up, the MADRS and Beck scores covaried closely with the presence or absence of depressed mood. This depressive syndrome persisted over the three months in the majority of patients originally depressed.

Negative Symptoms, Tardive Dyskinesia and Depression in Chronic Schizophrenia

1989 ◽  
Vol 155 (S7) ◽  
pp. 99-103 ◽  
Author(s):  
Thomas R.E. Barnes ◽  
Peter F. Liddle ◽  
David A. Curson ◽  
Meena Patel
Keyword(s):  
Depressive Symptoms ◽  
Tardive Dyskinesia ◽  
Movement Disorder ◽  
Negative Symptoms ◽  
Signs And Symptoms ◽  
Chronic Schizophrenia ◽  
Drug Induced ◽  
Three Stages ◽  
Negative Syndrome ◽  
The Relationship

The existence of a definable and distinct negative syndrome within schizophrenia remains to be established (Barnes & Liddle, 1989). Addressing this issue, Sommers (1985) discusses three stages required to demonstrate validity for a syndrome. These are first, that the signs and symptoms must be shown to occur together. Second, operational definitions must be developed which will reliably identify and rate and features, and third, the relationships between the syndrome and other variables must be shown to be predictable. With respect to the second and third stages, this paper reports briefly on two recent studies which explored the relationship between negative features and other clinical features, specifically depressive symptoms and drug-induced movement disorder. The results of such studies (see also McKenna et al; and Lindenmayer & Kay, this volume) allow some assessment of the ability of the rating methods used to discriminate between negative symptoms and features such as drug-related bradykinesia and depressive features.

scholarly journals Paliperidone to Treat Psychotic Disorders

2021 ◽  
Vol 13 (3) ◽  
pp. 343-358
Author(s):  
Hormazd D. Minwalla ◽  
Peter Wrzesinski ◽  
Allison Desforges ◽  
Joshua Caskey ◽  
Brittany Wagner ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Schizoaffective Disorder ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Drug Information ◽  
The United States ◽  
Mental Illnesses ◽  
Positive Symptoms ◽  
Review Of The Literature ◽  
Second Generation Antipsychotics

Purpose of Review: This is a comprehensive review of the literature regarding the use of paliperidone in the treatment of schizophrenia and schizoaffective disorder. It covers the background and presentation of schizophrenia and schizoaffective disorder, as well as the mechanism of action and drug information for paliperidone. It covers the existing evidence of the use of paliperidone for the treatment of schizophrenia and schizoaffective disorder. Recent Findings: Schizophrenia and schizoaffective disorder lead to significant cognitive impairment. It is thought that dopamine dysregulation is the culprit for the positive symptoms of schizophrenia and schizoaffective disorder. Similar to other second-generation antipsychotics, paliperidone has affinity for dopamine D2 and serotonin 5-HT2A receptors. Paliperidone was granted approval in the United States in 2006 to be used in the treatment of schizophrenia and in 2009 for schizoaffective disorder. Summary: Schizophrenia and schizoaffective disorder have a large impact on cognitive impairment, positive symptoms and negative symptoms. Patients with either of these mental illnesses suffer from impairments in everyday life. Paliperidone has been shown to reduce symptoms of schizophrenia and schizoaffective disorder.

Clinical Experience with Aripiprazole Treatment in Ten Elderly Patients with Schizophrenia or Schizoaffective Disorder: Retrospective Case Studies

CNS Spectrums ◽  
2004 ◽  
Vol 9 (11) ◽  
pp. 862-867 ◽  
Author(s):  
Subramoniam Madhusoodanan ◽  
Ronald Brenner ◽  
Sanjay Gupta ◽  
Harsha Reddy ◽  
Olivera Bogunovic
Keyword(s):  
Elderly Patients ◽  
Tardive Dyskinesia ◽  
Clinical Global Impression ◽  
Schizoaffective Disorder ◽  
Negative Symptoms ◽  
Clinical Symptoms ◽  
Retrospective Case ◽  
Clinical Global Impression Scale ◽  
Scale Scores ◽  
Positive And Negative Symptoms

ABSTRACTBackground: Clinical trials of aripiprazole, a recentl Food and Drug Administration-approved atypical antipsychotic, included elderly patients, but more data are needed on the effects of aripiprazole in this population, especially those with comorbid medical illnesses.Objective: To assess the response and safety of aripiprazole treatment in elderly patients with phrenia or schizoaffective disorder.Method: Data was obtained by retrospective review of medical records. Aripiprazole was used to treat 10 elderly hospitalized patients between 62 and 85 years of age who manifested signs of psychosis related to schizophrenia or schizoaffective disorder. All patients had been treated previously with atypical and classic antipsychotics. Response was assessed by clinical observation of patients' behavior and Clinical Global Impression Scale assigned retrospectively.Results: Seven patients responded to treatment, two did not respond, and one had a partial response. The mean Clinical Global Impression Scale scores improved from 6 (severely ill) at baseline to 2.3 (much improved) at discharge. Treatment was discontinued in the two patients who did not respond. Of the seven patients who responded, four presented with positive symptoms and showed significant improvement while three presented with positive and negative symptoms and both symptoms improved significantly. Four patients had preexisting extrapyramidal symptoms (EPS) and these symptoms decreased in three patients. In addition, two patients were able to discontinue antiparkinson medications. One patient who had severe tardive dyskinesia showed significant improvement in the dyskinetic symptoms. Four patients showed postural hypotension (without clinical symptoms) which resolved over time without treatment. Six patients showed a mean weight loss of 5.2 lbs. No adverse consequences occurred when divalproex sodium, carbamazepine, clonazepam or citalopram were given concurrently.Conclusion: The reduction of both positive and negative symptoms of schizophrenia and the lack of significant EPS, tardive dyskinesia, sedation, weight gain, anticholinergic effects, and QTc prolongation gives preliminary indication that aripiprazole may be a safe and effective medication for elderly patients with schizophrenia or schizoaffective disorder.

Akathisia: Prevalence and Associated Dysphoria in an In-patient Population with Chronic Schizophrenia

1994 ◽  
Vol 164 (2) ◽  
pp. 177-183 ◽  
Author(s):  
Simon M. Halstead ◽  
Thomas R. E. Barnes ◽  
Jeremy C. Speller
Keyword(s):  
Tardive Dyskinesia ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Significant Relation ◽  
Orofacial Dyskinesia ◽  
Increased Risk ◽  
Depot Antipsychotic ◽  
Male Patients ◽  
Higher Doses ◽  
Dysphoric Mood

In a sample of 120 long-stay in-patients who fulfilled DSM–III–R criteria for schizophrenia, chronic akathisia and pseudoakathisia were relatively common, with prevalence figures of 24% and 18%, respectively. Compared with patients without evidence of chronic akathisia, those patients with the condition were significantly younger, were receiving significantly higher doses of antipsychotic medication, and were more likely to be receiving a depot antipsychotic. Patients who experienced the characteristic inner restlessness and compulsion to move of akathisia also reported marked symptoms of dysphoria, namely tension, panic, irritability and impatience. The findings support the suggestion that dysphoric mood is an important feature of akathisia. Male patients appeared to be at an increased risk of pseudoakathisia. No significant relation was found between chronic akathisia and tardive dyskinesia, although there was a trend for trunk and limb dyskinesia to be commonest in patients with chronic akathisia while orofacial dyskinesia was most frequently observed in those with pseudoakathisia. Akathisia may mask the movements of tardive dyskinesia in the lower limb. There was no evidence that akathisia was associated with positive or negative symptoms of schizophrenia nor with depression.

scholarly journals Increasing prevalence of anticholinergic medication use in older people in England over 20 years: Cognitive Function and Ageing Study I and II

2019 ◽  
Author(s):  
Carlota Grossi ◽  
Kathryn Richardson ◽  
George Savva ◽  
Chris Fox ◽  
Antony Arthur ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Older People ◽  
Mini Mental State Examination ◽  
Medication Use ◽  
Anticholinergic Medication ◽  
Older Population ◽  
Clinically Significant ◽  
State Examination ◽  
Anticholinergic Burden

Abstract Background: Anticholinergic medication use is linked with increased cognitive decline, dementia, falls and mortality. The characteristics of the population who use anticholinergic medication are not known. Here we estimate the prevalence of anticholinergic use in England’s older population in 1991 and 2011, and describe changes in use by participant’s age, sex, cognition and disability. Methods: We compared data from participants aged 65+ years from the Cognitive Function and Ageing Studies (CFAS I and II), collected during 1990-1993 (N=7,635) and 2008-2011 (N=7,762). We estimated the prevalence of potent anticholinergic use (Anticholinergic Cognitive Burden [ACB] score=3) and average anticholinergic burden (sum of ACB scores), using inverse probability weights standardised to the 2011 UK population. These were stratified by age, sex, Mini-Mental State Examination score, and activities of daily living (ADL) or instrumental ADL (IADL) disability. Results: Prevalence of potent anticholinergic use increased from 5.7% (95% Confidence Interval [CI] 5.2-6.3%) of the older population in 1990-93 to 9.9% (9.3-10.7%) in 2008-11, adjusted odds ratio of 1.90 (95%CI 1.67 – 2.16). People with clinically significant cognitive impairment (MMSE [Mini Mental State Examination] 21 or less) were the heaviest users of potent anticholinergic in CFAS II (16.5% [95%CI 12.0-22.3%]). Large increases in the prevalence of the use medication with ‘any’ anticholinergic activity were seen in older people with clinically significant cognitive impairment (53.3% in CFAS I to 71.5% in CFAS II). Conclusions: Use of potent anticholinergic medications nearly doubled in England’s older population over 20 years with some of the greatest increases amongst those particularly vulnerable to anticholinergic side-effects. Key words: cognitive impairment, anticholinergic burden, polypharmacy

Tardive Dyskinesia

1992 ◽  
Vol 160 (1) ◽  
pp. 110-112 ◽  
Author(s):  
Robertson Macpherson ◽  
Rachel Collis
Keyword(s):  
Cognitive Function ◽  
Tardive Dyskinesia ◽  
Psychiatric Hospital ◽  
Negative Symptoms ◽  
Cognitive Deficit ◽  
Defect State ◽  
Abnormal Involuntary Movements ◽  
Involuntary Movements ◽  
Short Test

Of 113 patients in long-stay wards of a psychiatric hospital, 43 had TD. Twenty-six of the 39 patients who consented to take part in the study were unaware of abnormal involuntary movements. These patients scored significantly lower on a short test of cognitive function than patients who were aware of such movements. The diagnosis of schizophrenia, perticularly the ‘defect’ state with cognitive deficit and negative symptoms, was found to be associated with lack of awareness of TD.

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