Recognizing the Differences Between Tardive Dyskinesia and Drug-Induced Parkinsonism
Researchers conducted a literature review to locate articles on drug-induced parkinsonism (DIP) and tardive dyskinesia (TD) that related to the presentation, pathophysiology, epidemiology, and management of the disorders to note key differences between them. The presentation of DIP is often bradykinesia and rigidity, including rhythmic tremor, with the most cases seen within hours to weeks after the initiation of treatment with an antipsychotic or increase in dosage of an antipsychotic. The presentation of TD is often delayed, showing signs after at least 3 months or more of treatment with involuntary and abnormal facial movements. DIP can be resolved after discontinuing the therapy that caused it, but TD can be permanent. It is crucial for clinicians to be able to identify DIP and TD in those taking antipsychotics so that they are able to select the correct treatment and lessen adverse effects, improving patient quality of life.
Neuropsychiatric Assessment Through Telepsychiatry
A study sought to determine if the Abnormal Involuntary Movement Scale (AIMS), which relies on visual judgements, can be a reliable measurement tool through video chat. AIMS scores were examined by 2 independent raters in face-to-face contact and 2 raters assessing remotely through audio-visual transmission. Intraclass Correlation Coefficient was used to determine inter-rater reliabilities. No considerable difference was found between the raters, which may be due to the condition while examining involuntary movements using the AIMS. Researchers noted that the results were dependable to the same degree.
Lithium and Tardive Dyskinesia
On the Psychiatry & Behavioral Health Learning Network, Dr. Goldberg discusses the link between lithium and tardive dyskinesia (TD). While rare, Dr. Goldberg states that there is evidence of lithium causing TD in case reports. He also states what the course of action may be for someone who has taken lithium for 30 years who has suddenly developed shaking.
Drugs That Cause Tardive Dyskinesia
Tardive dyskinesia (TD) is mainly caused by the prolonged use of antipsychotic therapies. There are newer atypical antipsychotic therapies that are only sometimes linked to TD that include olanzapine, quetiapine, risperidone, paliperidone, and amisulpride. Other drugs that may cause TD include metoclopramide, antihistamines, fluoxetine, and amoxapine. When a patient is diagnosed with TD, treatment may include a reevaluation and adjustment of medications. There are available treatments to aid in counteracting the symptoms of TD. Those with schizophrenia, developmental disabilities, and other neuropsychiatric disorders may be more susceptible to TD if they are prescribed dopamine-receptor blocking therapies.
