Language
Country/Area
No result found
Why is tardive dyskinesia a threat after long-term medication use?
Tardive dyskinesia (TD) is a movement disorder caused by long-term use of certain drugs. It is common in patients who take long-term nerve-blocking drugs. Although this condition has attracted widespread attention from the medical community over the past few decades, its impact and harm remain underappreciated. Symptoms of TD include involuntary repetitive movements, such as facial distortion, tongue sticking out, lip flapping, etc. These uncontrollable movements not only affect the patient's daily life, but also cause great psychological pain.
"Tardive dyskinesia is most common in patients who continue to use antipsychotic drugs for mental illness."
Studies have found that approximately 20% of TD patients face severe functional impairment in their lives. And when this movement disorder occurs in the context of long-term drug use, its reversibility depends primarily on the severity of the symptoms and the duration of their occurrence. Common triggers are dopamine blockers, including antipsychotics and certain anti-nausea medications, often used to treat psychiatric, gastrointestinal or neurological problems. The development of TD often takes months to years of drug use.
“A pitfall of dependence on these drugs over time may be that at higher doses, users may not see immediate signs of TD until symptoms appear after stopping the drug. ”
Unfortunately, early symptoms of tardive dyskinesia are often misdiagnosed as other mental illnesses, resulting in patients being continued to be prescribed nerve blockers, increasing the risk of developing a serious condition. Older people, women, and patients with comorbid mood disorders or other physical illnesses are at higher risk of developing TD.
Symptoms and diagnosis
The main symptoms of tardive dyskinesia are involuntary repetitive movements, including distortions of facial expressions, flapping of lips, and rapid involuntary movements of limbs. These symptoms are typically characterized by the patient's continued inability to adapt to the social environment, which may lead to impairment of body functions. In terms of diagnosis, doctors usually make an assessment by observing the patient's face and conduct detailed testing based on the Abnormal Involuntary Movement Scale (AIMS).
"The purpose of AIMS is to determine the severity of a patient's movement disorder, not just its presence. This test can help doctors continue to track patients' symptoms."
Cause
Although the exact mechanism of tardive dyskinesia is unknown, many studies suggest that it may be due to increased sensitivity of dopamine receptors. Long-term use of older-generation antipsychotics is associated with a higher risk of TD, and the onset of this condition is strongly dose-related. Another possible explanation is that oxidative stress may also play a role in the development of this condition.
Prevention and treatment
The best way to prevent tardive dyskinesia is to use the smallest effective dose of a neuroleptic agent and to monitor the condition continuously. However, for some mental illnesses, especially chronic types, the contradiction between "balanced medication" and "relapse prevention" troubles many doctors. If a diagnosis is confirmed, key medications should, if possible, be discontinued.
"Although withdrawal of medication may worsen symptoms in the short term, this step is necessary in the long term."
The latest treatment options include vitamin E supplementation and inquiries into other antioxidants, and these findings suggest a relatively reduced incidence of TD after administration. In addition, the FDA approved several new drugs in 2017 to specifically treat TD, including Valbenazine and its congeners.
For patients, this disease not only causes physical distress, but also has an emotional impact. Therefore, medical staff need to pay more attention to the overall well-being and mental health of their patients. As our understanding of tardive dyskinesia continues to improve, will it be possible to develop more effective preventive measures and treatments in the future?
