Tardive Dyskinesia in Psychiatric Patients with Substance Use Disorders

Olivera, Arturo A.; Kiefer, Matthew; Manley, N K

doi:10.3109/00952999009001572

Cited by 53 publications

(22 citation statements)

References 10 publications

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“…For a MA user with acute and transient psychosis, the intervention approach will be more focused on psychosocial treatment for the MA use disorder, preventing relapse and recurrence of psychotic symptoms, and psychoeducation concerning the MA use-psychosis relationship. Likewise, accurate diagnosis, particularly during the early stages of psychotic disorder onset, can have a profound impact on treatment outcome and, importantly, minimizes the likelihood of medical mismanagement [see 21,22], including unnecessary exposure to neuroleptics or other antipsychotic medications [e.g., 23] or failure to treat potentially harmful withdrawal syndromes due to the effects of another substance, such as alcohol [e.g. 24].…”

Section: Clinical Features Of Psychosis In Methamphetamine Usersmentioning

confidence: 99%

Methamphetamine Psychosis: Epidemiology and Management

Glasner‐Edwards¹,

Mooney²

2014

CNS Drugs

199

161

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Psychotic symptoms and syndromes are frequently experienced among individuals who use methamphetamine, with recent estimates of up to approximately 40% of users affected. Though transient in a large proportion of users, acute symptoms can include agitation, violence, and delusions, and may require management in an inpatient psychiatric or other crisis intervention setting. In a subset of individuals, psychosis can recur and persist and may be difficult to distinguish from a primary psychotic disorder such as schizophrenia. Differential diagnosis of primary versus substance-induced psychotic disorders among methamphetamine users is challenging; nevertheless, with careful assessment of the temporal relationship of symptoms to methamphetamine use, aided by state-of-the art psychodiagnostic assessment instruments and use of objective indicators of recent substance use (i.e., urine toxicology assays), coupled with collateral clinical data gathered from the family or others close to the individual, diagnostic accuracy can be optimized and the individual can be appropriately matched to a plan of treatment. The pharmacological treatment of acute methamphetamine-induced psychosis may include the use of antipsychotic medications as well as benzodiazepines, although symptoms may resolve without pharmacological treatment if the user is able to achieve a period of abstinence from methamphetamine. Importantly, psychosocial treatment for methamphetamine dependence has a strong evidence base and is the optimal first-line treatment approach to reducing rates of psychosis among individuals who use methamphetamines. Prevention of methamphetamine relapse is the most direct means of preventing recurrence of psychotic symptoms and syndromes. Long-term management of individuals who present with recurrent and persistent psychosis, even in the absence of methamphetamine use, may include both behavioral treatment to prevent resumption of methamphetamine use and pharmacological treatment targeting psychotic symptoms. In addition, treatment of co-occurring psychiatric disorders including depression and anxiety is important as a means of preventing relapse to methamphetamine use, which is often triggered by associated symptoms.

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Section: Clinical Features Of Psychosis In Methamphetamine Usersmentioning

confidence: 99%

Methamphetamine Psychosis: Epidemiology and Management

Glasner‐Edwards¹,

Mooney²

2014

CNS Drugs

199

161

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“…Experimental studies demonstrate that ethanol inhibits striatal dopamine release (Woodward and Gonzales, 1990). Probably related is the observation that neurolepticinduced tardive dyskinesia is more common among drinkers (Olivera et al, 1990). In general, dyskinesias develop 2 weeks after the last drink but may also occur during heavy alcohol abuse.…”

Section: Alcoholmentioning

confidence: 98%

Movement Disorders and Substance Abuse

Williams¹

2004

CONTINUUM: Lifelong Learning in Neurology

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Almost all types of movement disorders can be caused or exacerbated by substance abuse. Abnormal movements are especially common with alcohol, and the number of reported cases related to cocaine, amphetamine, and heroin abuse continues to rise and diversify. These movements can present acutely or insidiously and occur during intoxicated and withdrawal states due to structural or metabolic abnormalities. Most of these disorders are extrapyramidal in nature and are attributed to altered dopaminergic neurotransmission in the basal ganglia or their connections. Neurologic dysfunction is usually reversible but may persist or even progress with repeated exposure. Treatment should be individualized and centered on drug rehabilitation. Substance abuse should be considered as an important trigger of abnormal movements, especially if there is sudden onset or acute exacerbation.

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“…This patient group may also have a higher risk of developing extrapyramidal side effects [105] , and a possibly additive effect for orthostatic hypotension. As a consequence, careful dosing and close monitoring for EPS and blood pressure are needed.…”

Section: Minimizing Side Effectsmentioning

confidence: 99%

Pharmacotherapy of patients with schizophrenia and substance abuse

Wobrock

Soyka

2009

Expert Opinion on Pharmacotherapy

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Background : Comorbid substance-use disorder in schizophrenia patients is associated with poor clinical and functional outcome. Objective : To provide evidence-based pharmacological treatment recommendations to improve the disease course of this patient group. Methods : A comprehensive systematic review of the pharmacological studies in this subgroup of patients was performed and the available studies were discussed from the standpoint of evidence-based medicine. Results/conclusion : Slight advantages were found for second-generation antipsychotic agents over conventional antipsychotics with regard to improvement of distinct psychopathological symptoms, reduced craving, and greater reduction of substance use; these findings are mainly derived from open studies or case series. Additional treatment with antidepressants, depending on the patient's psychopathology, as well as with anti-craving agents should be considered.

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Tardive Dyskinesia in Psychiatric Patients with Substance Use Disorders

Cited by 53 publications

References 10 publications

Methamphetamine Psychosis: Epidemiology and Management

Methamphetamine Psychosis: Epidemiology and Management

Movement Disorders and Substance Abuse

Pharmacotherapy of patients with schizophrenia and substance abuse

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