Tardive dyskinesia: Prevention and newer management strategies
| Autor: | Suyog Vijay Jaiswal, Sreelakshmi Vaidyanathan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Movement disorders business.industry lcsh:RC435-571 medicine.medical_treatment General Medicine Tardive dyskinesia medicine.disease Clonazepam Abnormal involuntary movement Electroconvulsive therapy vmat2 inhibitors tardive dyskinesia Deutetrabenazine lcsh:Psychiatry drug-induced dyskinesia medicine movement disorders Valbenazine medicine.symptom Intensive care medicine Antipsychotic business medicine.drug |
| Zdroj: | Annals of Indian Psychiatry, Vol 4, Iss 1, Pp 10-19 (2020) |
| ISSN: | 2588-8366 2588-8358 |
| Popis: | Tardive dyskinesia (TD) is a condition where we have a limited understanding of the cause and of management. The delayed-onset movements can occur due to prolonged exposure to dopamine receptor-blocking agents (DRBAs). They can be physically disabling and lead to ridicule and stigmatization. TD also interferes with treatment adherence. The increased trend of prescriptions for off-label use of various DRBAs, especially antipsychotics, has increased the risk of TD. No currently available antipsychotic is free of the risk of TD, though the atypicals have a lower risk. The Abnormal Involuntary Movements Scale is the most widely used and recommended tool for the assessment and monitoring of TD. Varied treatment strategies have been tried including cessation of the DRBA, switch to a lower potency antipsychotic, and concomitant use of other medications such as clonazepam and Vitamin E. Most of these strategies have minimal evidence. The recent US Food and Drug Administration approval of two VMAT2 inhibitors, deutetrabenazine and valbenazine, for the treatment of TD has brought some relief to these patients. Cost may be a limiting factor in their use. Nonpharmacological treatment such as deep-brain stimulation, botulinum toxin, and electroconvulsive therapy is to be used only in intractable/incapacitating movements. Despite these newer options, the best strategy in the management of TD continues to be prevention. Judicious use of antipsychotics, regular monitoring of patients on DRBAs, and early diagnosis and intervention are strategies that significantly reduce the development of TD and improve the quality of life of patients. |
| Databáze: | OpenAIRE |
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