Identification and management of tardive dyskinesia: A case series and literature review

Khouzam, Hani Raoul

doi:10.1080/00325481.2015.1074031

Cited by 20 publications

(15 citation statements)

References 62 publications

(118 reference statements)

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“…The healthcare provider must use caution when prescribing antipsychotics and perform regular screening for TD. Other strategies may include reduction in the dosage of the atypical antipsychotic, switching to clozapine, or administering Vesicular Monoamine Transporter (VMAT)-2 inhibitors [2]. In addition, Khouzam, supports that the AIMS is widely used to detect TD and to track its severity periodically [2].…”

Section: Literature Reviewmentioning

confidence: 99%

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Implementing the Abnormal Involuntary Movement Scale AIMS As an Evidence Based Practice Screening Tool in Adult Patients Taking Antipsychotics to Detect and Treat Tardive Dyskinesia

Madubueze¹,

Hammonds²,

Lindfors³

2019

J Psychiatry

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Background: Tardive Dyskinesia (TD) is possibly a permanent involuntary movement condition that is caused by all antipsychotics including atypical antipsychotics and typical antipsychotics. TD is also a socially stigmatizing disorder. The most recommended management strategy for TD is prevention. Objective: The aim was to improve quality of care for patients with the implementation of the Abnormal Involuntary Movement Scale (AIMS) as a screening tool in adult patients aged 18 to 65 years old taking antipsychotic medications. Methods/Design: This was a quality improvement project. A total of 60 adult patients were recruited but only 40 participated in the quality improvement project. The Abnormal Involuntary Movement Scale as a screening tool was implemented in the outpatient private practice from September 15 through November 16, 2018. The screening tool was implemented by the Doctor of Nursing Practice (DNP) student during each patient visit, followed by a review of scores to increase screening for TD. The DNP student was able to improve patient outcomes by identifying TD and making referrals for treatment. The World Health Organization Quality of Life instrument (WHOQOL-BREF) was used to assess the quality of life of patients taking antipsychotics. Results: The implementation of the AIMS in the routine monitoring for TD in adult patients improved patient outcomes with detection and treatment of tardive dyskinesia in adult patients taking antipsychotic medications with increased screening protocol from 0% to 80% within 12 weeks. The WHOQOL-BREF assessed the quality of life of adult patients taking antipsychotics and did not indicate any changes in the quality of life of patients. Conclusion: Implementing the AIMS improved quality of care in adult patients taking antipsychotics in the outpatient private practice.

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Section: Literature Reviewmentioning

confidence: 99%

“…TD is also a possibly permanent involuntary movement syndrome from extensive use of Dopamine Receptor-Blocking Agents (DRBAs). Amongst others, DBRAs include antipsychotics [2]. TD has a high incidence of 20%-25% and has been linked to poor quality of life in patients taking antipsychotics.…”

Section: Introductionmentioning

confidence: 99%

Implementing the Abnormal Involuntary Movement Scale AIMS As an Evidence Based Practice Screening Tool in Adult Patients Taking Antipsychotics to Detect and Treat Tardive Dyskinesia

Madubueze¹,

Hammonds²,

Lindfors³

2019

J Psychiatry

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“…Tardive dyskinesia (TD) and levodopa-induced dysknesia (LID) may both result from dysregulation of the direct and indirect pathways. TD is potentially caused by a heightened sensitivity of the D2 receptor from chronic DA blockade, decreasing indirect pathway activity and allowing for the breakthrough of abnormal movements [1]. Chronic DA replacement may increase sensitivity of the D1 receptor resulting in hyperactivity of the direct pathway allowing for LID.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Secondary Chorea: A Review of the Current Literature

Feinstein

Walker

2020

Tremor and Other Hyperkinetic Movements

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Background: Chorea consists of involuntary movements affecting the limbs, trunk, neck or face, that can move from one body part to another. Chorea is conceptualized as being "primary" when it is attributed to Huntington's disease (HD) or other genetic etiologies, or "secondary" when it is related to infectious, pharmacologic, metabolic, autoimmune disorders, or paraneoplastic syndromes. The mainstay of the secondary chorea management is treating the underlying causative disorder; here we review the literature regarding secondary chorea. We also discuss the management of several non-HD genetic diseases in which chorea can be a feature, where metabolic targets may be amenable to intervention and chorea reduction. Methods: A PubMed literature search was performed for articles relating to chorea and its medical and surgical management. We reviewed the articles and cross-references of pertinent articles to assess the current clinical practice, expert opinion, and evidence-based medicine to synthesize recommendations for the management of secondary chorea. Results: There are very few double-blind randomized controlled trials assessing chorea treatments regardless of etiology. Most recommendations are based on small open-label studies, case reports, and expert opinion. Discussion: Treatment of secondary chorea is currently based on expert opinion, clinical experience, and small case studies, with limited evidence-based medical data. When chorea is secondary to an underlying infection, medication, metabolic abnormality, autoimmune process, or paraneoplastic illness, the movements typically resolve following treatment of the underlying disease. Tardive dyskinesia is most rigorously studied secondary chorea with the best evidence-based medicine treatment guidelines recommending the use of pre-synaptic dopamine-depleting agents. Even though there is an insufficient pool of EBM, small clinical trials, case reports, and expert opinion are valuable for guiding treatment and improving the quality of life for patients with chorea. Highlights: There is a dearth of well-controlled studies regarding the treatment of chorea. Expert opinion and clinical experiences are fundamental in guiding chorea management and determining successful treatment. In general, secondary chorea improves with treating the underlying medical abnormality; treatments include antibiotics, antivirals, immunosuppression, dopamine depleting agents, chelation, and supportive care.

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“…Although TD has been far less reported than tardive dyskinesia, it is frequently more disabling than dyskinesia 123. Whereas complete remission of tardive dyskinesia had been reported in a case series,4 no complete remission occurred in a series of 29 TD patients 5…”

Section: Introductionmentioning

confidence: 99%

Tardive Dystonia Related with Aripiprazole

Kim

Lee

Kim

et al. 2017

Psychiatry Investig

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Tardive dystonia is characterized by sustained, generally slow involuntary twisting movements. It is estimated to occur at a frequency of 1% to 4% among patients who are taking an antipsychotic agent. Unlike the first generation antipsychotics, the second generation antipsychotics are less likely to cause neuroleptic-induced movement disorder. For aripiprazole, only a few cases have been reported for tardive dystonia. We present a young male, who developed a severe tardive dystonia after taking aripiprazole for 5 years. The patient was admitted to for the treatment of both hisdystonic and psychotic symptoms. Olanzapine was administered instead of aripiprazole and while his psychotic symptoms improved, the dystonic symptoms were continued. Therefore, olanzapine was switched to clozapine while augmenting with benzodiazepine, anti-cholinergic, and ginko biloba to control his tardive dystonia. After 2 weeks of treatment, the dystonic movement decreased remarkably.

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Identification and management of tardive dyskinesia: A case series and literature review

Cited by 20 publications

References 62 publications

Implementing the Abnormal Involuntary Movement Scale AIMS As an Evidence Based Practice Screening Tool in Adult Patients Taking Antipsychotics to Detect and Treat Tardive Dyskinesia

Implementing the Abnormal Involuntary Movement Scale AIMS As an Evidence Based Practice Screening Tool in Adult Patients Taking Antipsychotics to Detect and Treat Tardive Dyskinesia

Treatment of Secondary Chorea: A Review of the Current Literature

Tardive Dystonia Related with Aripiprazole

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