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1.
Nervenarzt ; 90(5): 472-484, 2019 May.
Artigo em Alemão | MEDLINE | ID: mdl-30341543

RESUMO

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.


Assuntos
Antipsicóticos , Transtornos Psicóticos , Discinesia Tardia , Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Humanos , Transtornos Psicóticos/tratamento farmacológico , Discinesia Tardia/induzido quimicamente
2.
Nervenarzt ; 90(1): 1-11, 2019 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-30128734

RESUMO

Acute antipsychotic-induced movement disorders (AIMD) are clinically relevant since they are frequently associated with high subjective distress, and since over the long-term they can negatively impact treatment adherence of patients with schizophrenic psychoses. This review article summarizes the relevant studies on the prevalence, risk factors, prevention and treatment options and instruments for early prediction of acute AIMD in schizophrenic psychoses. The current evidence and treatment recommendations are divided into three main areas: acute dystonia, akathisia, and parkinsonism. For the treatment of acute dystonia trihexyphenidyl and biperiden have shown their efficacy. Considering pharmacological treatment of akathisia, there is some preliminary evidence for medication with lipophilic beta-receptor blockers (propranolol and pindolol), clonidine, benzodiazepines, mianserin, mirtazapine und trazodone. The treatment options for drug-induced parkinsonism include reduction or switching from one antipsychotic to another with a lower affinity for dopamine D2 receptors, amantadine or in the regular administration of anticholinergic drugs. In conclusion, acute AIMD is easily to recognize but is not always effectively and durably treated. Early recognition and treatment of acute AIMD could be associated with improved treatment outcomes.


Assuntos
Acatisia Induzida por Medicamentos , Antipsicóticos , Distonia , Transtornos Parkinsonianos , Transtornos Psicóticos , Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Distonia/induzido quimicamente , Humanos , Transtornos Parkinsonianos/induzido quimicamente , Transtornos Psicóticos/tratamento farmacológico
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