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shabaz

Tardive Dyskinesia

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I am interested in carrying out some research on Tardive Dyskinesia

More about what happens to the patients with chronic schizophrenia and develop this iatrogenic condition.

What are the treatment options considered?

Has the prevalence declined with the advent of atypicals?

Is it worth treating and what is the evidence base for the different treatment options.

Considering schizophrenia is already a stigmatizing illness,does TD worsen this and someones quality of life?

What role can tetrabenazine(Xenazine) play in its management?

It appears that this can be given at low dose concomitantly with an antipsychotic, does anyone have clinical experience of this?

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Sounds like an interesring and worthwhile topic. I guess a good literature search would be an ideal starting point. Try Dialog Datastar:

http://www.athensams.net

Your NHS Trust library can give you access (username and password)

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I am interested in carrying out some research on Tardive Dyskinesia

More about what happens to the patients with chronic schizophrenia and develop this iatrogenic condition.

What are the treatment options considered?

Has the prevalence declined with the advent of atypicals?

Is it worth treating and what is the evidence base for the different treatment options.

Considering schizophrenia is already a stigmatizing illness,does TD worsen this and someones quality of life?

What role can tetrabenazine(Xenazine) play in its management?

It appears that this can be given at low dose concomitantly with an antipsychotic, does anyone have clinical experience of this?

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@j...

I know spontaneous dyskinesias like BLMS are seen in F20s... and there has been some studies that state that spontaneous dyskinesias are seen in never medicated F20s...

Could we call those tardive dyskinesia??? or does the word 'Tardive' specifically refer to late onset drug induced????

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exactly we were taught that it can occur in some patients,ie oral facial dyskinesia even without anti psychotic treatment.

Technically i don't think is the same entitity as tardive dyskinesia(drug induced) it could be another hyperkinetic movement disorder all together.

And probably has been lumped with tardive dyskinesia for medico legal purposes, so that patients who have tardive dyskinesia don't end up suing the pants off us psychiatrists

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@j...

I know spontaneous dyskinesias like BLMS are seen in F20s... and there has been some studies that state that spontaneous dyskinesias are seen in never medicated F20s...

Could we call those tardive dyskinesia??? or does the word 'Tardive' specifically refer to late onset drug induced????

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Thanks J it was a start,

Funny these days it seems the pendulum in the literature is swinging more to the typicals on the back drop of Cutlass, CATIE saying there is no difference in safety or efficacy between typicals and atypicals and so many papers out on metabolic syndrome,diabetes,obesity ect.. worsening the quality of life of patients with chronic schizophrenia.

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there's another recent paper on cost effectiveness which says typicals are more cost effective than atypicals (the first non-industry funded paper on this topic apparantly).

as for the pendulum - the furthest it ever really went towards the atypicals was to say that they may be more effective and that they may cause less EPSEs/TD, but that further research was needed to clarify that. optimism amongst clinicians together with marketing led to the common misconception that atypicals were better and had less side effects - i think most of us have believed those things at some point, but i think you are right that more and more people are moving towards the idea that all of the drugs have the potential to cause serious side effects and that there isn't a clear 'best' drug.

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The pendulum hangs on the nail which runs thru a sufferer's brain!! So ethics and morals on one side and cold money mindedness on the other. Oops as you can see I do feel strongly abt it!

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