Emerging Synthetic Cathinones and Psychostimulant-Related Movement Disorders

Researchers of a study looked into psychostimulants, a group of substances that have effects similar to amphetamine, methamphetamine, cocaine, or cathinone, highlighting connections between psychostimulant use and movement disorders.

The researchers noted that psychostimulant-related movement disorders are a known issue seen in emergency departments worldwide. Chronic and permanent movement disorders are less commonly encountered but can manifest as a combination of symptoms such as agitation, tremor, hyperkinetic and stereotypical movements, cognitive impairment, hyperthermia, and cardiovascular dysfunction. The underlying mechanisms of these disorders involve monoaminergic signaling, particularly dopamine, but other pathways are also involved. Researchers concluded that there are common mechanisms that connect the use of psychostimulants and various movement disorders.

Unraveling Tardive Syndrome: Involuntary Movements and Sensory Complaints Persist Despite New Antipsychotic Drugs

Researchers in a recent study gathered information on tardive syndrome (TS) as TS continues to persist despite the availability of newer antipsychotic drugs. TS is a secondary syndrome resulting from the use of dopamine receptor-blocking agents, and it can manifest in different forms such as dyskinesia, dystonia, akathisia, tremors, and parkinsonism. These symptoms often persist even after discontinuing the medication and may worsen over time. Treatment options for TS involve discontinuation or replacement of the medication with atypical antipsychotics like quetiapine or clozapine. Additionally, dopamine depleters such as tetrabenazine and its derivatives (deutetrabenazine and valbenazine) are used to alleviate symptoms with fewer side effects. Deep brain stimulation of the globus pallidus internus has also shown effectiveness in treating TS, particularly when medications fail to improve symptoms.

Link Between Antidepressants and Tardive Dyskinesia Explored

In a recent study, researchers critiqued various reviews and case reports associating non-dopamine-receptor-blocking drugs (DRBDs) with a tardive dyskinesia (TD) like syndrome, examining if the cases met TD criteria and excluded DRBD use. Their findings indicate that both tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitor antidepressants (SSRIs) may reveal or worsen TD in individuals previously exposed to or using DRBDs; however, they found minimal evidence supporting TD’s existence outside of this context.

Understanding Tardive Dyskinesia

The author of this article gives an overview of tardive dyskinesia (TD). TD can potentially be a permanent movement disorder that is caused by dopamine receptor blocking agents (DRBAs) in chronically using them. There are several risk factors associated with TD including certain genetic factors, female sex, African and Caucasian ethnicity, older age, illness duration along with cumulative dose of DRBA, and use of first-generation antipsychotics. Approximately 25% of psychiatric patients taking antipsychotic medication are estimated to have TD, representing a minority compared with the amount of people taking these medications. Prevention of TD is crucial, as stopping the medication causing TD does not always relieve the condition; however, there is no certain way to predict who will develop TD once starting DRBA use.

Impact of Genetic Factors in Tardive Dyskinesia

In a review, authors worked to summarize studies that have been completed in animal model experiments and clinical studies that are concentrated on genetic variations and their impact on the incidence of tardive dyskinesia (TD). The authors note that, in addition to the importance of drug- and dose-related factors in the development of TD, individual susceptibility and genetic predisposition are also crucial components to consider. Through their review, eight genes were recognized from preclinical findings that achieved considerable significance in one study or more.