Tardive

Tardive dysphoria (TDp) is a phenomenon characterized by the delayed onset or worsening of depressive symptoms following the discontinuation or alteration of antidepressant medications. TDp is a recently defined, under-recognized, and understudied condition. We present a series of five TDp cases exploring the diverse presentations, management strategies, and associated medical conditions. In all the cases, TDp manifested after prolonged use of selective serotonin reuptake inhibitors (SSRIs). All cases were successfully managed with atypical antidepressants...

BACKGROUND: Valbenazine is used for tardive movement disorders in adults. Current studies on its safety are mostly from clinical trials and small case reports, limiting information on rare adverse reactions. This study investigated valbenazine-related adverse event (AE) risk signals using the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database. METHODS: Valbenazine AEs data were collected from the FAERS database from 2017 Q2 to 2023 Q1, employing methods like reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network, and empirical Bayesian geometric mean...

Clozapine, amongst antipsychotics, has a unique composite mode of action that might translate into an expanded therapeutic potential on clinical grounds. Sorely, clozapine remains underutilized.

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INTRODUCTION: Deutetrabenazine is a vesicular monoamine transporter 2 inhibitor used to treat tardive dyskinesia (TD) and chorea associated with Huntington disease (HD). To enhance detection of safety signals across individual trials, integrated safety analyses of deutetrabenazine in TD and HD chorea were conducted. METHODS: For TD, safety data were integrated from two 12-week pivotal studies (ARM-TD and AIM-TD) and through week 15 of the open-label extension (OLE) study (RIM-TD)...

Palatal tremor has been subdivided into essential (EPT) and symptomatic palatal tremor (SPT). Progressive ataxia and palatal tremor syndrome (PAPT) is a subgroup of symptomatic palatal tremor (SPT). It can be divided into familial and sporadic forms. Sporadic PAPT is characterized by progressive cerebellar degeneration. The cause of sporadic PAPT remains uncertain. MRI examination found an enlarged appearance of the olivary nuclei with increased signal intensity on T2 and FLAIR images. Here we report a case of a mid-adult-onset man which presents a worsening cerebellar progressive ataxia with palatal tremor, in whom imaging reveals abnormalities of the olivary nuclei with tardive cerebellar atrophy which has been diagnosed as a sporadic PAPT...

Tardive dyskinesia (TD) is an involuntary muscle movement typically caused by prolonged exposure to antipsychotic medications. Depending on the symptom severity and the affected body parts, it can cause a terrible decline in patients' daily activities and life quality. TD often persists despite discontinuation of the offending drugs. There was no approved or effective agent to treat the patients until valbenazine, a vesicular monoamine transporter-2 inhibitor, became available. We report the case of a 64-year-old woman who started to take antipsychotics at the age of her late 20s for her schizophrenic symptoms and later developed left arm chorea-ballism in mid-50s...

Drug-induced movement disorders (DIMDs) are associated with use of dopamine receptor blocking agents (DRBAs), including antipsychotics. The most common forms are drug-induced parkinsonism (DIP), dystonia, akathisia, and tardive dyskinesia (TD). Although rare, neuroleptic malignant syndrome (NMS) is a potentially life-threatening consequence of DRBA exposure. Recommendations for anticholinergic use in patients with DIMDs were developed on the basis of a roundtable discussion with healthcare professionals with extensive expertise in DIMD management, along with a comprehensive literature review...

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BACKGROUND: Tardive Dyskinesia (TD) is a neurological disorder characterized by involuntary movements, often caused by dopamine receptor antagonists. Vesicular Monoamine Transporter 2 (VMAT2) inhibitors, such as valbenazine and deutetrabenazine, have emerged as promising therapies for TD and several clinical trials have shown their efficacy. This study aims to compare the efficacy and safety profile of VMAT2 inhibitors, focusing on a recent trial conducted in the Asian population. METHODS: We reviewed the PubMed, Cochrane Library, Embase database, and clinicaltrials...

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BACKGROUND: Minimum clinically important difference ( MCID) is the smallest change in an outcome measure that is considered clinically meaningful. Using validated MCID thresholds for outcomes powers trials adequately to detect meaningful treatment effects, aids in their interpretation and guides development of new outcome measures. OBJECTIVES: To provide a comprehensive summary of MCID thresholds of various symptom severity scales reported in movement disorder. METHODS: We conducted systematic review of the literature and included studies of one or more movement disorders, and reporting MCID scales...

BACKGROUND: Jaw clonus refers to involuntary, rhythmic jaw contractions induced by a hyperactive trigeminal nerve stretch reflex; however, the movements, when triggered without a stretch, can be confused with a tremor. PHENOMENOLOGY SHOWN: This video demonstrates a patient with amyotrophic lateral sclerosis presenting with rapid rhythmic jaw movements seen at rest, alongside a power spectrum analysis revealing a narrow high-frequency peak of 10 Hz. EDUCATIONAL VALUE: Rhythmic jaw movements are seen in many disorders such as Parkinson's disease, essential tremor, tardive syndromes, and cranial myorhythmias; however, a high-frequency movement, regardless of clonus or tremor, can indicate amyotrophic lateral sclerosis when accompanied by typical upper and lower motor neuron signs...

PURPOSE: This post hoc analysis investigated whether a patient's underlying psychiatric disease (schizophrenia/schizoaffective disorder [SCHZ] or bipolar disorder/depressive disorder [MOOD]) influenced the efficacy or safety of valbenazine for tardive dyskinesia (TD) in an Asian population. METHODS: We analyzed data from J-KINECT, a multicenter, phase II/III, randomized, double-blind study, which consisted of a 6-week placebo-controlled period followed by a 42-week extension where Japanese patients with TD received once-daily 40- or 80-mg valbenazine...

Tardive dyskinesia (TD) is a movement disorder that can arise as a side effect of treatment with dopamine receptor-blocking agents (DRBAs), including antipsychotic drugs (APDs) used to manage psychotic illnesses. Second-generation APDs (SGAs) are often preferred to first-generation drugs due to their lower propensity to cause TD, however many SGAs-treated patients still develop the condition. Although TD is a global health concern, evidence regarding the occurrence of TD and how it is managed in Asian countries is currently limited...

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No abstract text is available yet for this article.

The differential diagnosis of chorea encompasses a broad range of disorders. In psychiatry, tardive dyskinesia may be difficult to discern from other causes, particularly when the family history is negative. A 59-year-old man with an unclear medical history had been using risperidone for over a decade when we first saw him. He presented with severe dyskinesia in all extremities. The family history for neuropsychiatric disorders was negative. We interpreted the movement disorder as tardive dyskinesia, but later he turned out to suffer from Huntington’s disease...

BACKGROUND: Evening primrose oil (EPO), extracted from the seeds of Oenothera biennis, has gained attention for its therapeutic effects in various inflammatory conditions. METHOD: We performed a systematic search in multiple databases and defined the inclusion criteria based on the following PICOs: P: Patients with a form of inflammatory condition, I: EPO, C: Placebo or other therapeutic interventions, O: changes in inflammatory markers or patients' symptoms; S: randomized controlled trials...

Movements disorders are frequently encountered in general practice and emergency departments and are in many cases of iatrogenic origin. Dopamine D2 receptor blocking agents (DRBA), mainly neuroleptics, are most often incriminated. These drug-induced movement disorders (DIMD) can be classified according to the kinetics of the manifestations (acute DIMD and tardive syndromes), the phenomenology of the abnormal movements observed or depending on the pharmacological agent involved. The diagnosis is based on the time course of the events, clinical examination and meticulous anamnesis of the patient's previous and current treatments...