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Zhang D, Law S, Sediqzadah S. Tardive dyskinesia's under-recognition in the era of COVID-19. Schizophr Res 2024; 266:88-89. [PMID: 38377872 DOI: 10.1016/j.schres.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/23/2024] [Accepted: 02/10/2024] [Indexed: 02/22/2024]
Affiliation(s)
- Derek Zhang
- Department of Psychiatry, University of Toronto, 250 College St, Toronto, ON M5T 1R8, Canada.
| | - Samuel Law
- Department of Psychiatry, University of Toronto, 250 College St, Toronto, ON M5T 1R8, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada
| | - Saadia Sediqzadah
- Department of Psychiatry, University of Toronto, 250 College St, Toronto, ON M5T 1R8, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada
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Bhidayasiri R, Phokaewvarangkul O, Shang HF, Lim TT, Cho JW, Pal PK, Watanabe H. Tardive dyskinesia in Asia- current clinical practice and the role of neurologists in the care pathway. Front Neurol 2024; 15:1356761. [PMID: 38419696 PMCID: PMC10901179 DOI: 10.3389/fneur.2024.1356761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Tardive dyskinesia (TD) is a movement disorder that can arise as a side effect of treatment with dopamine receptor-blocking agents (DRBAs), including antipsychotic drugs (APDs) used to manage psychotic illnesses. Second-generation APDs (SGAs) are often preferred to first-generation drugs due to their lower propensity to cause TD, however many SGAs-treated patients still develop the condition. Although TD is a global health concern, evidence regarding the occurrence of TD and how it is managed in Asian countries is currently limited. This article reports the results of a systematic review of the published literature on TD focusing on its prevalence, types of patients, knowledge of the condition, causative factors, and usual treatment pathways in clinical practice in Asian countries. Epidemiological data suggest that the prevalence of TD is increasing globally due to an overall rise in APD use, contributing factors being polypharmacy with multiple APDs, the use of higher than necessary doses, and off-label use for non-psychotic indications. Although exact prevalence figures for TD in Asian countries are difficult to define, there is a similar pattern of rising APD use which will result in increasing numbers of TD patients in this region. These issues need to be addressed and strategies developed to minimize TD risk and manage this disabling condition which impacts patients' quality of life and daily functioning. To date, both research into TD has been predominantly psychiatry focused and the perspectives from neurologists regarding the clinical management of this challenging condition are scarce. However, neurologists have an essential role in managing the movement disorders manifestations that characterize TD. Optimum management of TD, therefore, should ideally involve collaboration between psychiatrists and neurologists in joint care pathways, wherever practical. Collaborative pathways are proposed in this article, and the challenges that will need to be addressed in Asian countries to improve the care of people with TD are highlighted, with a focus on the neurologist's viewpoint and the implications for the management of TD globally.
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Affiliation(s)
- Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
| | - Onanong Phokaewvarangkul
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Hui-Fang Shang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Thien Thien Lim
- Neurology Unit, Island Hospital, Georgetown, Penang, Malaysia
| | - Jin Whan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Hirohisa Watanabe
- Department of Neurology, Fujita Health University, Toyoake, Aichi, Japan
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Yoshida K. Botulinum Toxin Therapy for Oromandibular Dystonia and Other Movement Disorders in the Stomatognathic System. Toxins (Basel) 2022; 14:282. [PMID: 35448891 PMCID: PMC9026473 DOI: 10.3390/toxins14040282] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/01/2022] [Accepted: 04/11/2022] [Indexed: 01/02/2023] Open
Abstract
Various movement disorders, such as oromandibular dystonia, oral dyskinesia, bruxism, functional (psychogenic) movement disorder, and tremors, exist in the stomatognathic system. Most patients experiencing involuntary movements due to these disorders visit dentists or oral surgeons, who may be the first healthcare providers. However, differential diagnoses require neurological and dental knowledge. This study aimed to review scientific advances in botulinum toxin therapy for these conditions. The results indicated that botulinum toxin injection is effective and safe, with few side effects in most cases when properly administered by an experienced clinician. The diagnosis and treatment of movement disorders in the stomatognathic system require both neurological and dental or oral surgical knowledge and skills, and well-designed multicenter trials with a multidisciplinary team approach must be necessary to ensure accurate diagnosis and proper treatment.
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Affiliation(s)
- Kazuya Yoshida
- Department of Oral and Maxillofacial Surgery, National Hospital Organization, Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan
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Ha CA, Maguire GA. Case Report: Deutetrabenazine as an Adjunctive Treatment for Stuttering. Front Psychiatry 2021; 12:683368. [PMID: 34759847 PMCID: PMC8574968 DOI: 10.3389/fpsyt.2021.683368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Childhood-Onset Fluency Disorder (Stuttering) is a neurodevelopmental disorder in which disturbances occur in the normal fluency and time patterning of speech. While the dopamine system has been well-described in its neurophysiology, there currently is no FDA-approved treatment for stuttering. Second-generation antipsychotics, which have been effective in the treatment of schizophrenia and bipolar disorder, act as dopamine D-2 receptor antagonists at the postsynaptic neuron and have been shown to reduce the symptoms of stuttering. However, the D-2 receptor antagonist and partial agonist agents carry the potential for metabolic side effects and can potentially lead to movement disorders. Deutetrabenazine, a VMAT-2 inhibitor indicated to treat hyperkinetic movement disorders, is a potential candidate in the treatment of stuttering, based on its mechanism of action in decreasing dopamine activity while not carrying the risk of metabolic adverse events.
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Affiliation(s)
- Catherine A Ha
- School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Gerald A Maguire
- Department of Psychiatry and Neuroscience, University of California, Riverside, Riverside, CA, United States
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Chen CY, Chiang HL, Fuh JL. Tardive syndrome: An update and mini-review from the perspective of phenomenology. J Chin Med Assoc 2020; 83:1059-1065. [PMID: 32956105 DOI: 10.1097/jcma.0000000000000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Tardive syndrome (TS) is a group of movement disorders caused by the long-term use of dopamine receptor blocking agents. The phenotypic presentation of TS is diverse, ranging from the most well-characterized symptom of tardive dyskinesia to other symptoms, including dystonia, akathisia, myoclonus, parkinsonism, tremor, and tics. These tardive symptoms are distinct not only in their phenomenology but also in their clinical outcomes. However, our knowledge of the pathophysiology and management of TS is almost exclusively based on tardive dyskinesia. First-generation antipsychotics have a higher risk of inducing TS and have largely been replaced by second-generation antipsychotics with a lower risk of TS. However, patients with off-label use of second-generation antipsychotics are still at risk of developing TS. Thus, the management of TS remains a challenging and important issue for physicians. In this review, we update the information on the epidemiology, phenomenology, and treatment of TS from the perspective of the specific form of TS.
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Affiliation(s)
- Chun-Yu Chen
- Department of Medicine, Taipei Veterans General Hospital Yuli Branch, Hualian, Taiwan, ROC
| | - Han-Lin Chiang
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Jong-Ling Fuh
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan, ROC
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Rissardo JP, Caprara ALF. Cinnarizine- and flunarizine-associated movement disorder: a literature review. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00197-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Cinnarizine (CNZ) and flunarizine (FNZ) belong to the calcium channel blockers class of medication.
Main text
The aim of this literature review is to evaluate the clinical epidemiological profile, pathological mechanisms, and management of CNZ/FNZ-associated movement disorder (MD). Relevant reports in six databases were identified and assessed by two reviewers without language restriction. One hundred and seventeen reports containing 1920 individuals who developed a CNZ/FNZ-associated MD were identified. The MD encountered were 1251 parkinsonism, 23 dyskinesias, 11 akathisia, 16 dystonia, and 5 myoclonus, and in the group not clearly defined, 592 extrapyramidal symptoms, 19 tremors, 2 bradykinesia, and 1 myokymia. The predominant sex was female with a percentage of 72.69% (466/641). The mean age was 74.49 (SD, 7.88) years. The mean CNZ dose was 148.19 mg (SD, 42.51) and for the FNZ dose, 11.22 mg (5.39). The mean MD onset and recovery were 1.83 years (SD, 1.35) and 3.71 months (SD, 1.26). In the subgroup of subjects that had improvement of the symptoms, the complete recovery was achieved within 6 months of the drug withdrawal in almost all subjects (99%). The most common management was drug withdrawal. A complete recovery was observed in 93.77% of the patients (437/466).
Conclusions
CNZ/FNZ-associated MD was extensively reported in the literature. Parkinsonism was the most well described. Myoclonus (MCL) was the poorest described MD with missing data about the neurological examination and electrodiagnostic studies. The knowledge of this disorder probably can contribute to the understanding of the other drug-induced MDs.
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Touafchia D, Montastruc F, Lapeyre-Mestre M, Rousseau V, Chebane L, Revet A. Drug-induced tics: An observational postmarketing study. Hum Psychopharmacol 2020; 35:e2734. [PMID: 32352603 DOI: 10.1002/hup.2734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVES While drug-induced tics have been described, in particular with neuroleptics, psychostimulants, or anti-epileptics, the strength and the direction of these associations are still debated. The aim of this study was to investigate the association between tics and drug exposure through a two-step analysis in two pharmacovigilance databases. METHODS We first performed a descriptive clinical analysis of cases registered in the French pharmacovigilance database (FPVD) from January 1985 to December 2018. We then performed a disproportionality analysis in VigiBase®, the WHO pharmacovigilance database, from January 1967 to June 2019, through the calculation of reporting odds ratio (ROR). RESULTS The drugs most frequently associated with tics in the FPVD were methylphenidate, lamotrigine, montelukast, tramadol, mirtazapine, venlafaxine, aripiprazole, and risperidone. In VigiBase®, we found a significant ROR with methylphenidate (ROR 37.54, 95% confidence interval [CI] 34.81-40.48), montelukast (ROR 12.18, 95% CI 10.29-14.41), aripiprazole (ROR 7.40, 95% CI 6.35-8.62), risperidone (ROR 4.40, 95% CI 3.72-5.21), and venlafaxine (ROR 1.52, 95% CI 1.14-2.03). CONCLUSION This postmarketing study confirmed a potential harmful association with methylphenidate (the highest association, as expected), aripiprazole, risperidone, lamotrigine, and venlafaxine and, interestingly, found a strong signal with montelukast, which, to our knowledge, had never been published before.
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Affiliation(s)
- Davy Touafchia
- Service de Pharmacologie Médicale et Clinique, Centre de Pharmacovigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, CHU de Toulouse, Faculté de Médecine, Toulouse, France
| | - François Montastruc
- Service de Pharmacologie Médicale et Clinique, Centre de Pharmacovigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, CHU de Toulouse, Faculté de Médecine, Toulouse, France.,UMR 1027 Inserm, Université Toulouse III, Toulouse, France.,CIC 1436 CHU de Toulouse, Toulouse, France
| | - Maryse Lapeyre-Mestre
- Service de Pharmacologie Médicale et Clinique, Centre de Pharmacovigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, CHU de Toulouse, Faculté de Médecine, Toulouse, France.,UMR 1027 Inserm, Université Toulouse III, Toulouse, France.,CIC 1436 CHU de Toulouse, Toulouse, France
| | - Vanessa Rousseau
- Service de Pharmacologie Médicale et Clinique, Centre de Pharmacovigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, CHU de Toulouse, Faculté de Médecine, Toulouse, France
| | - Leila Chebane
- Service de Pharmacologie Médicale et Clinique, Centre de Pharmacovigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, CHU de Toulouse, Faculté de Médecine, Toulouse, France
| | - Alexis Revet
- Service de Pharmacologie Médicale et Clinique, Centre de Pharmacovigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, CHU de Toulouse, Faculté de Médecine, Toulouse, France.,UMR 1027 Inserm, Université Toulouse III, Toulouse, France.,Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Toulouse, Toulouse, France
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Covariation between motor signs and negative symptoms in drug-naive subjects with schizophrenia-spectrum disorders before and after antipsychotic treatment. Schizophr Res 2018; 200:85-91. [PMID: 28864283 DOI: 10.1016/j.schres.2017.08.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/18/2017] [Accepted: 08/20/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To examine the covariation between negative symptoms and motor signs in a broad sample of drug-naïve subjects with schizophrenia-spectrum psychoses before and after inception of antipsychotic medication. METHODS One-hundred and eighty-nine antipsychotic-naïve subjects with DSM-IV schizophrenia-spectrum psychoses were assessed for negative symptoms including affective flattening, alogia, avolition/apathy and anhedonia/associality, and motor signs including catatonia, parkinsonism and dyskinesia. We examined the association between negative and motor features at baseline, 4-weeks after inception of antipsychotic treatment and that of their mean change over the treatment period, such as their trajectories and treatment response pattern. RESULTS At the drug-naïve state, motor signs were strongly related to affective flattening and alogia (p<0.01); at 4-weeks, most negative and motor features were significantly interrelated (p<0.01); mean change of motor signs and negative symptoms tended to be unrelated. This association pattern was irrespective of levels of positive symptoms. Ratings of negative symptoms, excepting affective flattening, improved after treatment (p<0.001) while motor ratings showed divergent trajectories with catatonia improving (p<0.001), parkinsonism worsening (p<0.001) and dyskinesia remaining unchanged (p>0.01). Although to a different extent, motor and negative features showed drug-responsive, drug-worsening, of drug-unchanged patterns of response to antipsychotic medication. The main predictors of negative and motor features in treated subjects were their corresponding baseline ratings (p<0.001). CONCLUSIONS Negative and motor features are differentiated, but to some extent, overlapping domains that are meaningfully influenced by antipsychotic medication. At the drug-naïve state, motor signs and the diminished expression domain of negative symptoms may share underlying neurobiological mechanisms.
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Bakke M, Henriksen T, Biernat HB, Dalager T, Møller E. Interdisciplinary recognizing and managing of drug-induced tardive oromandibular dystonia: two case reports. Clin Case Rep 2018; 6:2150-2155. [PMID: 30455910 PMCID: PMC6230632 DOI: 10.1002/ccr3.1548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 03/29/2018] [Accepted: 04/03/2018] [Indexed: 12/02/2022] Open
Abstract
Tardive dystonia is a risk factor in medical antipsychotic treatment. It often begins with repetitive involuntary jaw and tongue movements resulting in impaired chewing and detrimental effect on the dentition. The orofacial dysfunction may go unrecognized in a neurological setting. The diagnosis may be difficult so we suggest interdisciplinary collaboration.
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Affiliation(s)
- Merete Bakke
- Department of Odontology Faculty of Medical and Health Sciences University of Copenhagen Copenhagen Denmark
| | - Tove Henriksen
- Department of Neurology and Clinical Neurophysiology (Dystonia Clinic) Bispebjerg University Hospital University of Copenhagen Copenhagen Denmark
| | - Heidi Bryde Biernat
- Department of Neurology and Clinical Neurophysiology (Dystonia Clinic) Bispebjerg University Hospital University of Copenhagen Copenhagen Denmark
| | - Torben Dalager
- Department of Neurology and Clinical Neurophysiology (Dystonia Clinic) Bispebjerg University Hospital University of Copenhagen Copenhagen Denmark
| | - Eigild Møller
- Department of Neurology and Clinical Neurophysiology (Dystonia Clinic) Bispebjerg University Hospital University of Copenhagen Copenhagen Denmark
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D'Abreu A, Friedman JH. Tardive Dyskinesia-like Syndrome Due to Drugs that do not Block Dopamine Receptors: Rare or Non-existent: Literature Review. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2018; 8:570. [PMID: 30191087 PMCID: PMC6125739 DOI: 10.7916/d8ff58z9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 08/10/2018] [Indexed: 12/01/2022]
Abstract
Background Although tardive dyskinesia (TD) is most commonly defined as a movement disorder caused by chronic exposure to dopamine‐receptor‐blocking drugs (DRBDs), it has also been thought to result from exposure to some non‐DRBDs. Methods We critiqued many reviews making the association between non‐DRBDs and a TD‐like syndrome and almost all case reports. We checked whether cases met criteria for the diagnosis of TD‐like syndrome and whether DRBDs had been excluded. Results We found that both tricyclic antidepressants and selective serotonin reuptake inhibitor antidepressants may unmask or exacerbate TD after prior exposure to or with concurrent use of DRBDs. We found support for its existence outside of this context to be extremely weak. Discussion There is little evidence that drugs other than DRBDs by themselves cause a TD syndrome; most reported cases appear to occur as a result of a “priming” effect induced by a DRBD, which is later unmasked.
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Affiliation(s)
- Anelyssa D'Abreu
- Department of Neurology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Joseph H Friedman
- Department of Neurology, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
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D'Abreu A, Akbar U, Friedman JH. Tardive dyskinesia: Epidemiology. J Neurol Sci 2018; 389:17-20. [PMID: 29433811 DOI: 10.1016/j.jns.2018.02.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 02/02/2018] [Indexed: 01/05/2023]
Abstract
The term tardive syndrome (TS) encompasses a few different phenomenologic conditions, some of which occur in isolation and others in association with each other. This, along with the unusual confound for a drug side effect, in which increased use of the drug improves the problem, and the need for most patients to continue taking the offending drug, makes understanding the epidemiology difficult and unreliable. While the change from the "first generation" to the "second generation" of antipsychotic drugs is generally believed to have reduced the incidence of TS, prospective research studies have not supported that contention. Published reports have found point prevalences of 13% with second generation antipsychotics and 32% with first, yet others have found no differences. One study found increasing rates of TS with a 68% prevalence by 25 years, while another found a decreased prevalence over time, due presumably to masking effects of the antipsychotic drugs. Regardless of the possible differences, it is clear that TS remains a significant and common problem associated with almost all antipsychotic drugs. There have also been scattered reports of TS caused by drugs not known to inhibit dopamine receptors. These are reviewed and were found to be often of dubious reliability.
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Affiliation(s)
- Anelyssa D'Abreu
- Brown University, Department of Neurology, Providence, RI, United States; Rhode Island Hospital, Department of Neurology, Providence, RI, United States.
| | - Umer Akbar
- Brown University, Department of Neurology, Providence, RI, United States; Rhode Island Hospital, Department of Neurology, Providence, RI, United States
| | - Joseph H Friedman
- Brown University, Department of Neurology, Providence, RI, United States; Butler Hospital, Department of Neurology, Providence, RI, United States
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Acute Cervical Dystonia Induced by Clebopride. Case Rep Neurol Med 2017; 2017:2834349. [PMID: 29333306 PMCID: PMC5733119 DOI: 10.1155/2017/2834349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 11/05/2017] [Indexed: 11/17/2022] Open
Abstract
Antidopaminergic drugs are known to induce extrapyramidal symptoms. Clebopride, a dopamine antagonist, also can produce parkinsonism, tardive dyskinesia, tardive dystonia, hemifacial dystonia, or oculogyric crisis; however, acute dystonic reaction caused by clebopride has not been reported in adults. We report two young men who experienced acute cervical dystonia within a few days of taking clebopride. The patients recovered after discontinuation of the drug. Physicians prescribing clebopride should be aware of the adverse effects of this drug.
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Paliperidone Palmitate-Associated Severe Refractory Tardive Dyskinesia With Tardive Dystonia: Management and Six-Months Follow-Up. J Clin Psychopharmacol 2016; 36:391-3. [PMID: 27269958 DOI: 10.1097/jcp.0000000000000520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rizek P, Kumar N, Jog MS. An update on the diagnosis and treatment of Parkinson disease. CMAJ 2016; 188:1157-1165. [PMID: 27221269 DOI: 10.1503/cmaj.151179] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Philippe Rizek
- Department of Clinical Neurological Sciences, Western University, London, Ont
| | - Niraj Kumar
- Department of Clinical Neurological Sciences, Western University, London, Ont
| | - Mandar S Jog
- Department of Clinical Neurological Sciences, Western University, London, Ont.
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A Pharmacogenetic Discovery: Cystamine Protects Against Haloperidol-Induced Toxicity and Ischemic Brain Injury. Genetics 2016; 203:599-609. [PMID: 26993135 DOI: 10.1534/genetics.115.184648] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 03/15/2016] [Indexed: 12/22/2022] Open
Abstract
Haloperidol is an effective antipsychotic agent, but it causes Parkinsonian-like extrapyramidal symptoms in the majority of treated subjects. To address this treatment-limiting toxicity, we analyzed a murine genetic model of haloperidol-induced toxicity (HIT). Analysis of a panel of consomic strains indicated that a genetic factor on chromosome 10 had a significant effect on susceptibility to HIT. We analyzed a whole-genome SNP database to identify allelic variants that were uniquely present on chromosome 10 in the strain that was previously shown to exhibit the highest level of susceptibility to HIT. This analysis implicated allelic variation within pantetheinase genes (Vnn1 and Vnn3), which we propose impaired the biosynthesis of cysteamine, could affect susceptibility to HIT. We demonstrate that administration of cystamine, which is rapidly metabolized to cysteamine, could completely prevent HIT in the murine model. Many of the haloperidol-induced gene expression changes in the striatum of the susceptible strain were reversed by cystamine coadministration. Since cystamine administration has previously been shown to have other neuroprotective actions, we investigated whether cystamine administration could have a broader neuroprotective effect. Cystamine administration caused a 23% reduction in infarct volume after experimentally induced cerebral ischemia. Characterization of this novel pharmacogenetic factor for HIT has identified a new approach for preventing the treatment-limiting toxicity of an antipsychotic agent, which could also be used to reduce the extent of brain damage after stroke.
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Lerner PP, Miodownik C, Lerner V. Tardive dyskinesia (syndrome): Current concept and modern approaches to its management. Psychiatry Clin Neurosci 2015; 69:321-34. [PMID: 25556809 DOI: 10.1111/pcn.12270] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 11/15/2014] [Accepted: 12/22/2014] [Indexed: 12/31/2022]
Abstract
Tardive dyskinesia is a serious, disabling and potentially permanent, neurological hyperkinetic movement disorder that occurs after months or years of taking psychotropic drugs. The pathophysiology of tardive dyskinesia is complex, multifactorial and still not fully understood. A number of drugs were tried for the management of this motor disturbance, yet until now no effective and standard treatment has been found. It is very disappointing to realize that the introduction of antipsychotics from the second generation has not significantly decreased the prevalence and incidence of tardive dyskinesia. Therefore, the management of this motor disturbance remains an actual topic as well as a challenge for clinicians. This review summarizes recent relevant publications concerning the treatment of tardive dyskinesia.
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Affiliation(s)
- Paul P Lerner
- Faculty of Medicine, Bar-Ilan University, Tsfat, Israel
| | - Chanoch Miodownik
- Be'er-Sheva Mental Health Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Vladimir Lerner
- Be'er-Sheva Mental Health Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
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Waln O, Jankovic J. An update on tardive dyskinesia: from phenomenology to treatment. Tremor Other Hyperkinet Mov (N Y) 2013; 3:tre-03-161-4138-1. [PMID: 23858394 PMCID: PMC3709416 DOI: 10.7916/d88p5z71] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 05/30/2013] [Indexed: 12/01/2022] Open
Abstract
Tardive dyskinesia (TD), characterized by oro-buccal-lingual stereotypy, can manifest in the form of akathisia, dystonia, tics, tremor, chorea, or as a combination of different types of abnormal movements. In addition to movement disorders (including involuntary vocalizations), patients with TD may have a variety of sensory symptoms, such as urge to move (as in akathisia), paresthesias, and pain. TD is a form of tardive syndrome-a group of iatrogenic hyperkinetic and hypokinetic movement disorders caused by dopamine receptor-blocking agents. The pathophysiology of TD remains poorly understood, and treatment of this condition is often challenging. In this update, we provide the most current information on the history, nomenclature, etiology, pathophysiology, epidemiology, phenomenology, differential diagnosis, and treatment of TD.
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Affiliation(s)
- Olga Waln
- Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, United States of America
| | - Joseph Jankovic
- Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, United States of America
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Peralta V, Campos MS, De Jalón EG, Cuesta MJ. Motor behavior abnormalities in drug-naïve patients with schizophrenia spectrum disorders. Mov Disord 2010; 25:1068-76. [PMID: 20222137 DOI: 10.1002/mds.23050] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Prevalence and correlates of primary motor abnormalities in schizophrenia are presently ill defined. This study was aimed at examining the prevalence, syndromic structure, external correlates, and response to antipsychotic medication of a broad array of primary motor abnormalities. Two-hundred antipsychotic-naive patients with schizophrenia spectrum disorders were examined for motor abnormalities using the Modified Rogers Scale. Thirty-one motor signs were subjected to factor analysis, and the resulting factors examined for association with a number of risk factors, clinical and psychopathological variables. One-hundred and eighty-nine patients were reassessed for motor abnormalities after completing a 4-week trial with antipsychotic medication. Prevalence rates for at least one motor sign and syndrome at baseline were 66% and 40%, respectively. Motor signs clustered together into seven clinically interpretable factors: abnormal involuntary movements, hypokinesia, retarded catatonia, echo-phenomena, excited catatonia, catalepsy, and parkinsonism. All motor domains but parkinsonism were inter-related. Abnormal involuntary movements were associated with variables indicating both neurodevelopmental dysfunction and illness severity, and most motor domains were closely related to negative or disorganization symptoms. Change scores in motor domains after treatment with antipsychotic medication indicated improvement for abnormal involuntary movements, hypokinesia, retarded catatonia, excited catatonia and echophenomena, and worsening for parkinsonism. It is concluded that primary motor dysfunction is a prevalent and heterogeneous condition of schizophrenia. Motor abnormalities segregate into various syndromes, which have different clinical correlates and a differential response pattern to antipsychotic medication. It is hypothesized that the existence of a differential dopaminergic dysfunction in the nigroestriatal circuitry is responsible for the generation of those motor domains that improve and worsen with antipsychotic drugs.
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Affiliation(s)
- Victor Peralta
- Psychiatric Unit, Virgen del Camino Hospital, Pamplona, Spain.
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Peralta V, Cuesta MJ. The effect of antipsychotic medication on neuromotor abnormalities in neuroleptic-naive nonaffective psychotic patients: a naturalistic study with haloperidol, risperidone, or olanzapine. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2010; 12. [PMID: 20694120 DOI: 10.4088/pcc.09m00799gry] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Accepted: 04/16/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine the effect of antipsychotic medication on neuromotor abnormalities in a sample of psychotic patients never exposed to antipsychotic drugs. METHOD One hundred psychotic patients were assessed (from January 1998 to December 2002) using DSM-IV criteria for parkinsonism, dyskinesia, akathisia, catatonia, and dystonia at baseline and after 4 weeks of treatment with haloperidol (n = 23), risperidone (n = 52), or olanzapine (n = 25). We examined change scores in neuromotor ratings over the treatment period across treatment groups and rates of drug-responsive and drug-emergent neuromotor syndromes in patients with and without preexisting neuromotor abnormalities. RESULTS Overall time effects revealed a worsening of parkinsonism (P = .002) and akathisia (P = .002) ratings and an improvement of dyskinesia (P = .001) and catatonia (P < .001) ratings. Main treatment effects revealed that patients taking haloperidol had a significant mean increase in akathisia scores compared with those of patients taking risperidone (P = .002) or olanzapine (P < .001). A significantly greater percentage of olanzapine-treated patients experienced remission of preexisting parkinsonism than did the other treatment groups (P = .047). Patients without preexisting motor abnormalities were more likely to experience drug-emergent parkinsonism if they were treated with haloperidol or risperidone than with olanzapine (P = .001) and were more likely to experience drug-emergent dystonia (P = .014) and akathisia (P = .013) if they were treated with haloperidol than with risperidone or olanzapine. CONCLUSIONS The relationship between antipsychotic medication and neurologic abnormalities is more complex than previously acknowledged since antipsychotic drugs may both improve preexisting abnormalities and cause "de novo" neurologic syndromes. Overall, olanzapine has a more favorable neuromotor profile than risperidone, which in turn has a more favorable profile than haloperidol.
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Affiliation(s)
- Victor Peralta
- Psychiatric Unit, Virgen del Camino Hospital, Pamplona, Spain.
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Utari A, Adams E, Berry-Kravis E, Chavez A, Scaggs F, Ngotran L, Boyd A, Hessl D, Gane LW, Tassone F, Tartaglia N, Leehey MA, Hagerman RJ. Aging in fragile X syndrome. J Neurodev Disord 2010; 2:70-76. [PMID: 20585378 PMCID: PMC2882562 DOI: 10.1007/s11689-010-9047-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Accepted: 04/20/2010] [Indexed: 12/02/2022] Open
Abstract
Many studies have focused on the behavior and cognitive problems in young patients with fragile X syndrome (FXS), but there are no studies about the problems in aging for those with FXS. The discovery of the fragile X-associated tremor ataxia syndrome (FXTAS), a neurodegenerative disorder related to elevated FMR1-mRNA, in elderly men and some women with the premutation, intensified the need for aging studies in FXS. Approximately 40% of males with FXS have repeat size mosaicism and as a result, some of these individuals also have elevated levels of FMR1-mRNA which theoretically puts them at risk for FXTAS. Here, we have surveyed all of the aging patients with FXS that we have followed over the years to clarify the medical complications of aging seen in those with FXS. Data was collected from 62 individuals with the FXS full mutation (44 males; 18 females) who were at least 40 years old at their most recent clinical examination. We found that the five most frequent medical problems in these patients were neurological problems (38.7%), gastrointestinal problems (30.6%), obesity (28.8%), hypertension (24.2%) and heart problems (24.2%). Movement disorders were significantly different between males and females (38.6% vs.10.2%, p = 0.029). We did not find any differences in medical problems between those with a full mutation and those with mosaicism. Identification of medical problems associated with aging in FXS is important to establish appropriate recommendations for medical screening and treatment considerations.
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Affiliation(s)
- Agustini Utari
- Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California, Davis, Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
- Division of Human Genetics, Center for Biomedical Research, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Evan Adams
- Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California, Davis, Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Neurology, and Biochemistry, Rush-University Medical Center, Chicago, IL USA
| | - Alyssa Chavez
- Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California, Davis, Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Medical Center, Sacramento, CA USA
| | - Felicia Scaggs
- School of Medicine, Rush University Medical Center, Chicago, IL USA
| | - Lily Ngotran
- Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California, Davis, Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
| | - Antoniya Boyd
- Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California, Davis, Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
| | - David Hessl
- Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California, Davis, Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Medical Center, Sacramento, CA USA
| | - Louise W. Gane
- Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California, Davis, Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
| | - Flora Tassone
- Department of Biological Chemistry, University of California, Davis, School of Medicine, Davis, CA USA
| | - Nicole Tartaglia
- Department of Pediatrics, University of Colorado, Denver, School of Medicine, Aurora, CO USA
| | - Maureen A. Leehey
- Department of Neurology, University of Colorado, Denver, Aurora, CO USA
| | - Randi J. Hagerman
- Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California, Davis, Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
- Department of Pediatrics, University of California, Davis, Medical Center, Sacramento, CA USA
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Bota RG, Witkowski JW. Quetiapine Induced Acute Dystonia in a patient with History of severe Head Injury. Rehabil Process Outcome 2010. [DOI: 10.4137/rpo.s3626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A patient with a history of severe head injury 10 years ago regained ability to walk after years of being bound to a wheelchair. During the last psychiatric hospitalization, quetiapine was increased to therapeutic dose using a normal titration. As a result the patient developed dystonia of multiple muscle groups requiring 4 days of hospitalization for remittance of symptoms. In this paper, we take a close look at the literature concerning extrapiramidal symptoms (EPS) in this context, and we suggest that in patients with a history of head injury, it is warranted to consider a slower titration of antipsychotic medications, including ones that are considered having a lower risk of EPS such as quetiapine.
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Affiliation(s)
- Robert G. Bota
- Kaiser Permanente, Corona, CA
- University of Missouri Kansas City
| | - Joanne W. Witkowski
- Kaiser Permanente, Corona, CA
- Kaiser Permanente, Riverside, CA
- University of California, Riverside and University of California, Irvine
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Pelvic dyskinesia with an outstanding response to tetrabenazine. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33:847-8. [PMID: 19348867 DOI: 10.1016/j.pnpbp.2009.03.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 03/24/2009] [Accepted: 03/31/2009] [Indexed: 11/23/2022]
Abstract
We report on a patient who presented an invalidating progressive pelvic dyskinesia while receiving different kinds of neuroleptic drugs for a psychiatric disorder. The clinical features and different drug-induced movement scales showed an outstanding improvement after tetrabenazine was started. To the best of our knowledge, this is the first case report of pelvic dyskinesia with good evolution and control of dyskinesias after treatment with tetrabenazine.
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Su JA, Tsang HY, Chou SY, Chung PC. Aripiprazole treatment for risperidone-associated tic movement: a case report. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:899-900. [PMID: 18166258 DOI: 10.1016/j.pnpbp.2007.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2007] [Revised: 12/05/2007] [Accepted: 12/06/2007] [Indexed: 10/22/2022]
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Abstract
OBJECTIVE To report a patient with chronic blepharospasm possibly induced by the calcium-channel blocker cinnarizine. CASE REPORT A 53-year-old woman developed chronic blepharospasm during a prolonged therapy with calcium-channel blocker cinnarizine for the treatment of vertigo. CONCLUSIONS "Tardive blepharospasm" should be considered as a possible adverse effect of cinnarizine.
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Affiliation(s)
- Hortensia Alonso-Navarro
- Sección de Neurología, Hospital Virgen de la Concha, Zamora, and Departamento de Medicina-Neurología, Hospital Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
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Abstract
OBJECTIVE To report a patient with tardive tics possibly induced by the atypical neuroleptic drug amisulpride. CASE REPORT A 55-year-old woman developed motor and phonic tics after a prolonged treatment with amisulpride. Tics improved and finally disappeared after amisulpride withdrawal. CONCLUSIONS Tardive motor and phonic tics should be considered as a possible adverse effect of amisulpride.
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Abstract
Myoclonus is a sudden, abrupt, brief, 'shock-like' involuntary movement caused by muscular contractions ('positive myoclonus') or a sudden brief lapse of muscle contraction in active postural muscles ('negative myoclonus' or 'asterixis'). Various disorders can cause myoclonus including neurodegenerative and systemic metabolic disorders and CNS infections. In addition, myoclonus has been described as an adverse effect of some drugs. Level II evidence is available to indicate that levodopa, cyclic antidepressants and bismuth salts can cause myoclonus, while there is less robust evidence to associate numerous other drugs with the induction of myoclonus. The pharmacological mechanisms responsible for this adverse effect are not well established, although increased serotonergic transmission may be involved in the induction of myoclonus by several drugs. Drug-induced myoclonus usually resolves after withdrawal of the offending drug, but in some cases specific treatments are needed.
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Affiliation(s)
- Félix Javier Jiménez-Jiménez
- Department of Medicine - Neurology, Hospital "Príncipe de Asturias", Universidad de Alcalá, Alcalá de Henares, Madrid, SpainNeuro-Magister S.L. Company, Madrid, Spain.
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