Finally, Effective Treatments for Tardive Dyskinesia

Topics: Adjunct treatment | AIMS test (Assessment of Involuntary Movement) | Antipsychotics | Assent | Austedo | Deutetrabenazine | Ingrezza | Tardive dyskinesia | Tetrabenazine | Valbenazine | VMAT2 Inhibitors | Xenazine

Antipsychotics, especially first-generation antipsychotics, can cause tardive dyskinesia (TD) or abnormal involuntary movements of different areas of the body. For years, we have dreaded seeing our patients develop TD because there was little we could do about these symptoms. In 2017, the FDA approved two agents to treat TD, valbenazine (Ingrezza) and d

How to Treat Tardive Dyskinesia

Topics: Amantadine | Austedo | Deutetrabenazine | Ginkgo | Ingrezza | Keppra | Levetiracetam | Melatonin | Psychopharmacology | Psychopharmacology Tips | Side Effects | Tardive dyskinesia | Valbenazine | Vitamin B6 | Vitamin E | VMAT2 Inhibitors

Your patient is a 56-year-old male who recovered from a difficult-to-treat depression 4 years ago after quetiapine was added to his citalopram. As he talks, you notice that his fingers are tapping in a rapid, random pattern and his feet are wiggling. When questioned, he explains, “I just do that when I’m anxious.” Should you stop the antipsychotic

Antipsychotic Maintenance: How Long is Enough?

Topics: Antidepressant Augmentation | Antidepressants | Antipsychotics | Bipolar Disorder | Deprescribing | Depression | Depressive Disorder | Mania | Metabolic syndrome | Mood Stabilizers | olanzapine | Psychopharmacology | Psychopharmacology Tips | Risperidone | Side Effects | Tardive dyskinesia

Your 58-year-old patient started risperidone to augment lithium 2 years ago. It got her out of a severe mania, and she has stayed well since then. Now she’s worried about long-term risks and wondering if it’s time to come off. Augmentation with an atypical antipsychotic may offer rapid relief from mania and depression, but antipsychotics’ potenti

Are SSRIs Associated With Increased Rates of Violence?

Topics: Deprescribing | Mania on Antidepressants | Medication adherence | polypharmacy | Psychosis | Psychotic Depression | Schizophrenia | Tags | Tardive dyskinesia | Withdrawal

REVIEW OF: Lagerberg et al, Eur Neuropsychopharm 2020;26:1–9 TYPE OF STUDY: Analysis of Swedish national registries Soon after the introduction of SSRIs in 1988, case reports began to emerge suggesting that they might trigger violence in a small subset of patients. At the time, such reports were mostly dismissed and attributed to the fact that p

An Answer for Psychotic Depression

Topics: Antidepressants | Antipsychotics | Deprescribing | Depression | Depressive Disorder | olanzapine | Pharmacology | Pharmacology Tips | Psychosis | Psychotic Depression | Research | Research Update | Tardive dyskinesia

REVIEW OF: Flint AJ et al, JAMA 2019;322(7):622–631 TYPE OF STUDY: Randomized, placebo-controlled trial Psychotic features in depression indicate a more severe form of the disease, with a higher risk of hospitalization and double the rate of disability compared with non-psychotic depression. A combination of an antipsychotic and an antidepressant is