Effect of anticholinergics on tardive dyskinesia: A controlled study

The British Journal of Psychiatry (Impact Factor: 7.99). 10/1984; 145(SEP):304-10. DOI: 10.1192/bjp.145.3.304
Source: PubMed


In a double-blind, placebo-controlled study, ten chronic schizophrenic patients with pronounced symptoms of tardive dyskinesia (TD) were withdrawn from anticholinergic medication. All patients had previously been under long-term treatment with neuroleptics and anticholinergics for at least two years. The rating-scales used were the AIMS, our own TD Scale, and the Simpson-Angus scale for extra-pyramidal side-effects. The severity of TD decreased significantly in nine patients with in two weeks; this improvement, most pronounced in the oral region (P less than .001), persisted during a six-week placebo period. There was a slight increase in parkinsonian symptoms (P less than .05), which was not a prerequisite for improvement in TD. Hence, discontinuation of anticholinergic medication is a possible therapeutic approach in patients with TD.

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    • "Holi et al. (2004) showed that the TD symptoms are created just in 10% of those who use Clozapine (22). Nearly two- thirds of the patients suffer from a neuroleptic-induced movement disorder despite the relatively low antipsychotic doses and the use of anticholinergics(23, 24). This study shows that there is no significant difference in a comparison between typical and atypical medicines and the nine-fold detachment. "
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    ABSTRACT: Tardive Dyskinesia (TD), is one of the important problems of the patients with schizophrenia. The emergence of these side effects depends on so many factors such as the patients' age and the duration of antipsychotic treatment. By discovering new drugs (Atypical), there has been an outstanding decrease in the emergence of these side effects. The present study investigates the symptoms of TD in the Patients with schizophrenia who were under treatments for more than 6 months. The sample of this study was 200 Patients with schizophrenia of four wards in Razi hospital (two acute and two chronic wards) who were hospitalized in the winter of 2006 and were qualified for this study. The subjects were 101 males and 99 females who were younger than 60 and had received antipsychotic drugs for at least 6 months. After psychiatric interview and filling the demographic questionnaire by the patients, the required information about the drugs and the intensity of the symptoms was acquired. Then clinical and physical examinations of tardive dyskinesia were done. Next, the tardive dyskinesia disorders' check list (AIMS) was used. Findings of this cross-sectional, descriptive study were analyzed by SPSS. There was a high ratio of 95% between TD and the age factor (P=0.05). There was no relationship between symptoms frequency and duration of treatment (P=0.68). Facial muscles and oral zones were mostly involved in T.D disorder (72%). No significant difference was observed between nine fold symptoms of T.D in patients who were using traditional drugs and those who were using the new ones (typical and atypical). Findings showed that in the intensity of the symptoms, gender does not play a major role.
    Iranian Journal of Psychiatry 03/2010; 5(4):159-63.
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    • "Dyskinesia Rating Scale by Simpson et al. (1979) (Btichel et al. 1995). It should also be noted that the DMA values correlate well with the total and global TD scores, but it should be added that oral and extremity dyskinesias not always change in parallel (Greil et al. 1984). The lack of a correlation between the DMA and the ratings of the dyskinesia fluctuations over time in the present study further indicate that there is no complete correspondence between the instrumental and clinical evaluation. "
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    ABSTRACT: Digital movement analysis (DMA) is a new instrumental approach to assessing oral tardive dyskinesia (TD) by means of digital image processing of a video signal, tracking five paper dots placed around the patient's mouth. A total of 40 schizophrenic patients, 30 with and 10 without TD, were examined twice (with a 3-month interval) with this new device. The patients were further examined with two TD rating scales: the St. Hans Rating Scale for extrapyramidal syndromes (SHRS) and the Abnormal Involuntary Movement Scale (AIMS). The schizophrenic patients accepted the instrumental assessment without any anxiety or resistance. The internal reliability of the apparatus was high, with correlation coefficients of 0.80-0.99. The DMA TD values correlated with the SHRS and AIMS scores with correlation coefficients of 0.48-0.73 indicating an acceptable, although not strong, concurrent validity. Fluctuations occurred from the first to the second examination independent of medication. For these fluctuations no correlation was found between DMA values and rating scores. Finally, the DMA device was able to detect perioral tremor as a sign of parkinsonism. It has been concluded that DMA is a useful supplement to classical TD rating, although further validity evaluation is warranted.
    European Archives of Psychiatry and Clinical Neuroscience 02/1996; 246(2):71-7. DOI:10.1007/BF02274896 · 3.53 Impact Factor
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