Tardive dyskinesia
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Tardive dyskinesia is defined as involuntary movements of the tongue, lips, face, trunk, and extremities. It is primarily caused by long-term treatment with antipsychotic or anticholinergic drugs. The pathophysiology involves dopamine superssensitivity and an imbalance of dopamine and acetylcholine. Treatment involves clonazepam as a first line option or amantadine or tetrabenazine. The only way to prevent tardive dyskinesia is to avoid long-term treatment with antipsychotic drugs.
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Tardive dyskinesia
- 1. TARDIVE DYSKINESIA ”TD” الغامدي هللا غرم فارس
- 2. OBJECTIVES : Definition of Tardive dyskinesia Causes of Tardive dyskinesia Pathophysiology of Tardive dyskinesia Deferential diagnosis of Tardive dyskinesia Investigations for Tardive dyskinesia Treatment of Tardive dyskinesia Prevention of Tardive dyskinesia
- 4. DEFINITION OF TD : Tardive dyskinesia (TD) is involuntary movements of the tongue, lips, face, trunk, and extremities
- 5. CAUSES OF TD : Drugs : TD can be caused by long-term treatment with antipsychotic “dopamine antagonists” “anticholinergic drugs” GENS : TD has been associated with polymorphisms of the dopamine D3 receptor Ser9Gly the serotonin 2A [1] and 2C receptor genes.
- 6. PATHOPHYSIOLOGY OF TD : The dopamine supers sensitive theory The dopamine-acetycholine balance theory
- 7. DEFERENTIAL DIAGNOSIS OF TD : Chorea Epilepsy Syphilis Essential Tremor Thyroid diseases HIV-1 Associated Cerebrovascular Complications
- 8. INVESTIGATIONS OF TD : Usually the investigation to exclude the other disease in DDx - Thyroid function tests - Serum biochemistry CT, MRI, SPECT, and PET Findings from brain CT and MRI are typically normal in patients with TD. patients with TD may demonstrate increased glucose metabolism in the globus pallidus and the precentral gyrus
- 9. TREATMENT OF TD : According to “American Academy of Neurology” -clonazepam for TD as first line treatment -The drug amantadine might help treat TDS short-term -The drug tetrabenazine might help treat TDS
- 10. PREVENTION OF TD : The only certain method of TD prevention is to avoid treatment with antipsychotic drugs and metoclopramide. The use of antipsychotic drugs, particularly for > 3 months, requires careful evaluation and should be limited to situations it is important to inform patients of the risk of developing TD before treating with antipsychotic drugs