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Did you know? Uncovering the mystery of tardive dyskinesia caused by chronic drug therapy!
Tardive dyskinesia (TD) is a medically induced disorder in which patients experience involuntary, repetitive body movements. These movements may include facial contortions, tongue sticking out, or lip smacking. In approximately 20% of people with TD, the disorder affects their ability to function in daily life. As research deepens, the medical community is paying more and more attention to this issue, especially among those who have been receiving long-term treatment with dopamine receptor blocking drugs.
The development of tardive dyskinesia usually occurs only after months to years of medication, and once symptoms develop, their reversibility depends largely on the severity of the symptoms and how early they occur.
The root cause of tardive dyskinesia comes from long-term use of dopamine receptor blockers, such as psychiatric drugs and metoclopan. These drugs are primarily used to treat psychological disorders, but may also be used for gastrointestinal or nervous system problems. The diagnosis is based on the presence of symptoms and exclusion of other potential causes. Preventive measures include using the lowest effective dose or discontinuing psychiatric medications.
Treatment involves stopping the neuroleptic medication if possible (although this may temporarily worsen symptoms) or switching to a drug such as clazapine. Other drugs, such as valbenacin, tetrafloxacin, or botulinum toxin, may be used to relieve symptoms. Studies have shown that some patients see symptom relief after treatment, while others never recover. Statistics show that approximately 30% of users of conventional antipsychotics will develop this disease, while the proportion of users of atypical antipsychotics is about 20%.
Older people, women, and those with mood disorders or other medical diagnoses are more likely to develop tardive dyskinesia.
The condition, first described in 1964, is characterized by repetitive, involuntary movements. Common symptoms include facial grimace, tongue movements, lip smacking, and involuntary blinking. In some cases, individuals may also experience rapid involuntary movements of their limbs, torso, and fingers. The survey found that these symptoms are reversed in Parkinson's patients because they have difficulty moving.
Further troubling for patients, tardive dyskinesia is often misdiagnosed as a psychiatric disorder, leading patients to continue to be prescribed neuroleptic drugs, increasing the risk of developing severe and disabling symptoms.
To make an effective diagnosis, medical staff often observe the patient's facial movements to determine the presence of the disease. During this process, a test called the Abnormal Involuntary Movement Scale (AIMS) is used, which can effectively assess the degree of involuntary movements. The test responses range from no symptoms to severe discomfort, aiming to help doctors understand the patient's condition in a timely manner.
The exact mechanism of tardive dyskinesia is still unclear, but there are many studies supporting hypotheses such as dopamine hypersensitivity and oxidative stress.
The study also pointed out that smoking, old age, female and congenital brain damage will increase the risk of TD. Polymorphisms of certain genes are also related to the occurrence of this disease, and different people have different susceptibility to the disease. In this context, it is particularly important to choose appropriate treatment plans for patients and identify symptoms in a timely manner.
The best way to prevent tardive dyskinesia is to use the lowest effective dose of the drug and, when possible, to promptly stop the causative drug. However, for patients with chronic mental illness, such as schizophrenia, such a strategy needs to take into account the risk of recurrent depression.
In 2017, the FDA approved the use of valbenacin to relieve the symptoms of tardive dyskinesia. The medical community is actively exploring new drugs and treatment options to address this stubborn disease. Nowadays, patients' mental health and social adaptation issues are gradually receiving attention, which shows how important it is to have a comprehensive understanding of tardive dyskinesia.
So, in the face of the phenomenon of tardive dyskinesia that cannot be ignored, how should we increase awareness of this disease and ensure that patients receive better support and treatment?
