Has anyone heard of Tardive Dyskenesia?!
Question: one of my relatives suffers from this due to anti-psychotic medication (which he needs to take). Can it be treated?
Thanks xx
Answers: one of my relatives suffers from this due to anti-psychotic medication (which he needs to take). Can it be treated?
Thanks xx
Yes. It's a negative side effect due to the prolonged use of anti-psychotics.
Current anti-psychotics tend to produce less severe symptoms of tardive dyskinesia compared to meds a few decades ago.
Neuroleptic medications can be prescribed to "counter" the effects of tardive dyskinesia.
if he comes of the meds - NOT a good idea
Tardive dyskinesia
Tardive dyskinesia (TD) is a type of dystonia, a disorder of the central nervous system (brain and spinal cord) characterised by involuntary muscle contractions which force parts of the body into abnormal, and sometimes painful, movements or postures. Dystonias can affect any part of the body including the limbs, trunk, neck, eyelids, facial muscles and vocal cords.
TD is a secondary dystonia, mainly caused by the use of anti-psychotic drugs. These drugs are also called neuroleptics or major tranquillisers, and are used to treat psychotic states such as occur in schizophrenia, and sometimes in manic depression and severe depression. TD also occasionally occurs in people who have never been treated with antipsychotic medication.
TD is primarily associated with the older, typical antipsychotic drugs such as chlorpromazine (Largactil), and haloperidol (Haldol, Dozic) which cause the so-called extrapyramidal side-effects which mimic Parkinson's disease. There is a reduced risk of TD with the newer, atypical drugs such as olanzapine.
TD involves abnormal, involuntary and uncontrollable movements. It does not necessarily stop if medication is withdrawn, but may be a permanent side-effect in a significant number of people who develop it.
What does TD look like?
The involuntary movements usually begin with the face and mouth and cause grimacing, lip-smacking and tongue movements. They may also involve the rest of the body and produce involuntary gestures, tics and writhing movements. TD is socially disabling and at its worst is severely physically disabling.
What are the risks of TD developing?
The risk is dose-related, increasing with high doses of antipsychotic. TD is rare with less than six months treatment with antipsychotic drugs at low doses. It mainly occurs in people who have been on moderate to high doses of anti-psychotic medication for periods of six months to two years or more. However there have been rare reports of TD occurring when low doses were prescribed for relatively short periods. The overall risk is five per cent of cases per year of treatment with antipsychotic medication.
Estimates for the risks of TD to long-term users of antipsychotic drugs vary from five to 56 per cent; for people treated with antipsychotics for four years or longer, a widely accepted estimate is 20 per cent. The risk is higher for people on depot preparations.
Psychiatric research shows that women, children, older people, and people with mood disorders are particularly at risk of TD. Early signs of adverse effects of anti-psychotics such as Parkinsonism (eg shaking, stiffness, shuffling walk) indicate a greater risk; the threshold for developing Parkinsonism is the same as the threshold for developing TD. People who develop Parkinson's symptoms are likely to be given anti-Parkinson's drugs, and use of these is therefore also associated with TD. The World Health Organisation has issued a statement saying that anti-Parkinson's drugs should not be routinely given to people taking anti-psychotics. Stopping and starting anti-psychotics may contribute to the risk of TDs persisting once it has developed.
How common is TD?
The incidence (number of new cases per year) of TD among people taking the older antipsychotic drugs is five per cent. With atypical antipsychotic drugs, the incidence is less than one per cent per year. The prevalence (number in any population) is 20 per cent of those taking the older anti-psychotic drugs.
It is suggested that the risk is higher for women than for men.
Will it disappear if the medication is stopped?
If TD is identified early and medication is stopped, it may disappear.
With discontinuation of antipsychotics at any time, about half of patients will have spontaneous improvement in the symptoms, although such improvement is often delayed and may take up to five years. Stopping medication is not possible for some people, and the risk of relapse or psychosis must be balanced against the risk of TD. If medication is to be stopped this should be done gradually.
What other options are there if TD appears?
The antipsychotic might be substituted with one of the newer, atypical drugs such as clozapine, olanzapine, or quetiapine, which have all been found to reduce symptoms of TD. If anti-Parkinson's drugs are being prescribed for the adverse effects then stopping these is advised. There is evidence that clonazepam (a benzodiazepine used in epilepsy) may be a useful treatment, and Vitamin E appears to diminish TD in some cases. A number of studies have suggested that vitamin B6 may also be helpful.
TD is not necessarily progressive in all cases, and using the lowest possible dose of antipsychotic minimises the risk that it will get worse. Sometimes when drugs are withdrawn, withdrawal dyskinesias may occur. TD may also be unmasked during drug withdrawal. These are likely to diminish with time.
The Royal College of Psychiatrists Consensus Statement on the use of high dose antipsychotic medication suggests that in emergency situations where dangerous behaviour needs to be rapidly controlled, high doses of antipsychotic drugs can be avoided by using a combination of moderate doses of benzodiazepine and antipsychotic.
Hope this answers your question.
Sometimes TD is temporary and sometimes it is permanent. The best thing to do is for your relative to work closely with his psychiatrist to try to eliminate this side effect. The medication dosage can be reduced, or he might be switched to another antipsychotic. Sometimes the symptoms will lessen or stop if a different drug is substituted.
He should make sure the doctor takes his symptoms seriously and that he is troubled by them. Sometimes psychiatrists don't watch for TD closely enough or do not realize how devastating it can be for a patient. If the doctor does not seem caring or knowledgeable, maybe it's time to shop for a better one.
Restricted use of anti psychotic meds but then if there is no alternative then he should stay on them.
keeping the dose of anti psychotic to the lowest possible level.
be reassessed very three months, for continued treatment with a anti psychotics.
switching meds to one that has limited antagonism of dopamine receptors rather than a typical antipsychotic drug.
i dont think it can be treated only prevented and monitored.
Take care
xx
Your relative needs to talk to the doctor about the symptoms!!!
Make sure they get to the doctor and tell them what is going on!
I Have a mild case of tardive dyskenesia which developed over 30 years ago from massive doses of stelazine. It sucks. They tell me it is due to permanent nerve damage and is incurable and untreatable. I have been on risperdal for over 10 years which has not increased the symptoms. Karen M seems to know quite a bit about it in her answer.
I know many who have real severe symptoms. I feel for your relative.. good mental health, peace and Love!
There are treatments but it really never goes away.