Antipsychotic-induced motor symptoms in schizophrenic psychoses-Part 3 : Tardive dyskinesia

• Published in: Nervenarzt Vol. 90; no. 5; pp. 472 - 484
• Main Authors: Hirjak, D, Kubera, K M, Bienentreu, S, Thomann, P A, Wolf, R C
• Format: Journal Article
• Language: German
• Published: Germany 01.05.2019
• Subjects: Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Humans; Psychotic Disorders - drug therapy; Tardive Dyskinesia - chemically induced; Prevention; Therapy; Tardive dyskinesia; Early recognition; Risk factors
• ISSN: 1433-0407
• DOI: 10.1007/s00115-018-0629-7

The treatment of schizophrenic psychoses with antipsychotic drugs (AP) is often associated with an increased risk of delayed occurrence of antipsychotic-associated movement disorders. Persistence and chronicity of such symptoms are very frequent. The risk of developing tardive dyskinesia (TD) is associated with the pharmacological effect profile of a particular AP, with treatment duration and age. This systematic review article summarizes the current study situation on prevalence, risk factors, prevention and treatment options and instruments for early prediction of TD in schizophrenic psychoses. The current data situation on treatment strategies for TD is very heterogeneous. For the treatment of TD there is preliminary evidence for reduction or discontinuation of the AP, switching to clozapine, administration of benzodiazepines (clonazepam) and treatment with vesicular monoamine transporter (VMAT2) inhibitors, ginkgo biloba, amantadine or vitamin E. Although TD can be precisely diagnosed it cannot always be effectively treated. Early detection and early treatment of TD can have a favorable influence on the prognosis and the clinical outcome.