High Incidence and Prevalence of Drug-Related Movement Disorders in Young Patients With Psychotic Disorders

Mentzel, Thierry Q.; Lieverse, Ritsaert; Bloemen, Oswald; Viechtbauer, Wolfgang; Harten, Peter N. van

doi:10.1097/jcp.0000000000000666

Cited by 25 publications

(19 citation statements)

References 36 publications

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“…DIP has been associated with higher negative symptoms in the present sample, which is consistent with the results of previous studies 11,37 . This co-occurrence has been suggested to be due to a common neurobiological basis 38,39 .…”

Section: Discussionsupporting

confidence: 93%

Prevalence of and Risk Factors for Extrapyramidal Side Effects of Antipsychotics

Misdrahi¹,

Tessier²,

Daubigney³

et al. 2019

J. Clin. Psychiatry

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Background: Extrapyramidal side effects (EPS) have been identified as a complication of antipsychotic treatment. Previous meta-analyses have investigated EPS prevalence and risk factors in randomized clinical trials with highly selected patients, but studies in real-world schizophrenia are missing. Objectives: To examine the prevalence and clinical correlates associated with EPS in a nonselected national multicentric sample of stabilized patients with schizophrenia. Method: Between 2010 and 2016,patients suffering from schizophrenia (DSM-IV-TR) were recruited through the FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) network and data were collected during a comprehensive 1-day long standardized evaluation. The Simpson and Angus Scale and the Abnormal Involuntary Movement Scale were used to assess respectively Drug-Induced Parkinsonism (DIP) and Tardive Dyskinesia (TD). Results: The overall prevalence of DIP and TD was respectively 13.2% and 8.3% in our community-dwelling sample of 674 patients. DIP was associated with negative symptoms (PANSS sub-score) (aOR = 1.102, p<.001), First Generation Antipsychotic (FGA) (aOR = 2.038, p=.047) and anticholinergic drug administration (aOR = 2.103, p=.017) independently of sex, age, disorganization, and antipsychotic polytherapy. TD was associated with PANSS disorganized factor (aOR = 1.103, p=.049) independently of sex, age, negative symptoms, excitation, first-generation antipsychotic, benzodiazepine and anticholinergic drug administration. Conclusion: Our results indicate the high prevalence of EPS in a non-selected communitydwelling clinically stable sample of outpatients with schizophrenia. EPS should be systematically evaluated, especially in case of negative symptoms and disorganization or cognitive alteration in the monitoring of antipsychotic treatment. Monotherapy with an SGA should be preferentially initiated for patients with these sides-effects.

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Section: Discussionsupporting

confidence: 93%

Prevalence of and Risk Factors for Extrapyramidal Side Effects of Antipsychotics

Misdrahi¹,

Tessier²,

Daubigney³

et al. 2019

J. Clin. Psychiatry

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“…However, to our knowledge, a unilateral presentation of ataxia has not been described to date. Movement phenomena in children and adults with psychiatric conditions are not uncommon and include tic, stereotypy, chorea, and drug induced dyskinesias [ 13 , 14 ]. Depending on the etiologic substrate, these manifestations may be of variable degree and sometimes subtle in their presentation, with psychiatric signs outweighing manifestations of movement impairment [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Hemiataxia: A Novel Presentation of Anti-NMDA Receptor Antibody Mediated Encephalitis in an Adolescent

Phillips

Jones

Callaghan

et al. 2017

Case Reports in Psychiatry

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Anti-NMDA receptor antibody associated encephalitis as a cause of new-onset neuropsychiatric manifestations in children and adults can represent a significant diagnostic challenge for clinicians. Clinical signs often include encephalopathy, new-onset psychosis, and movement phenomenon. Although orofacial dyskinesias were initially identified as a characteristic movement phenomenon in this type of encephalitis, an expanded range of abnormalities has recently been reported, including isolated ataxia. We report a case of isolated hemiataxia in a young adult with mild initial psychiatric manifestations. A personal and family history of preceding neuropsychiatric symptoms produced diagnostic confusion and resulted in a significant diagnostic and therapeutic delay. Our case confirms the unilateral movement manifestations that have been emphasized in recent reports. Additionally, it confirms the need for involvement of neurologic as well as psychiatric services in the evaluation of such cases and emphasizes the importance of the neurologic examination in presentations with an initial psychiatric predominance.

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“…Drug-related movement disorders (DRMDs) as well as a variety of clinical outcomes were studied. The aim of the authors was to study the incidence, prevalence, and persistence rates of DRMDs at an early stage of the psychotic illness (schizophrenia and other non-affective psychoses), without prior treatment confounding [25]. Eligible patients for inclusion in the prevalence, incidence, and persistence analyses were 828 at baseline (age: 27 ± 7, illness duration, mean: 4 ± 4 years) and 447 at follow-up.…”

Section: Epidemiologymentioning

confidence: 99%

Tardive Dystonia due to D2 Antagonists and Other Agents

Σκώκου¹,

Tsermpini²,

Giamarelou³

et al. 2018

Dystonia - Different Prospects

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Tardive dystonia due to D2 antagonists or other agents is a potentially severe extrapyramidal side effect emerging after long-term drug treatment, prevalent but not limited to psychiatric populations. Its course is often deteriorating, and available treatments are frequently far from satisfying. It presents with sustained muscle contractions, abnormal postures, and repetitive twisting movements and leads to increased psychiatric morbidity, mortality, and decline of quality of life. Inadequate clinical skill and awareness of tardive dystonia can lead to neglect or misdiagnoses, considered as conversion symptoms or of psychogenic origin. Since the syndrome is persistent and often treatment resistant, prevention should be a mainstay of clinical care. Emerging evidence supports positive effects of atypical antipsychotics, particularly quetiapine and clozapine. Therapies such as tetrabenazine, valbenazine, deutetrabenazine, anticholinergics, baclofen, benzodiazepines, vitamin E, or non-pharmacologic interventions, namely botulinum toxin A, deep-brain stimulation, have been found to be helpful in some cases of tardive dystonia. This chapter comprehensively illustrates multiple aspects of this entity, including recent advances on etiology, pathophysiology, clinical presentation, epidemiology, pharmacogenomics, and treatment, aiming to enhance and deepen clinicians' and researchers' awareness of tardive dystonia, with the final goal of ameliorating patients' prognosis and quality of life.

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High Incidence and Prevalence of Drug-Related Movement Disorders in Young Patients With Psychotic Disorders

Cited by 25 publications

References 36 publications

Prevalence of and Risk Factors for Extrapyramidal Side Effects of Antipsychotics

Prevalence of and Risk Factors for Extrapyramidal Side Effects of Antipsychotics

Hemiataxia: A Novel Presentation of Anti-NMDA Receptor Antibody Mediated Encephalitis in an Adolescent

Tardive Dystonia due to D2 Antagonists and Other Agents

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