Ramzy Yassa

Nicotine exposure and tardive dyskinesia

The prevalence of tardive dyskinesia (TD) in chronic psychiatric outpatients was significantly higher in smokers (46/85) than in nonsmokers (18/69) (p less than 0.001). This increased prevalence was associated with a significantly greater prescribed dose of neuroleptics in women, but not in men. Nicotine increases the synthesis and release of dopamine in the nigrostriatal pathway of animals. Such a mechanism may contribute to the higher prevalence of TD in smokers. The present findings suggest that smoking is a risk factor for the development of TD. A statistically significant association between smoking and TD, however, does not necessarily imply a cause-effect relationship. Treatment of TD with mecamylamine or other central nicotine antagonists merits investigation.

Prevalence of bipolar disorder in a psychogeriatric population

Bipolar affective disorder arising for the first time in old age (60 years and over) has not been extensively studied. The authors present a prevalence study of mania arising after age 60. Of 217 patients admitted to our unit in a 2-year period, 10 (4.7%) showed symptoms of mania, using the DSM-III criteria. This constitutes 9.3% of 108 affective disorder patients admitted during the same period. An important factor in the precipitation of these attacks was marital discord, leading, in several cases, to separation, even in this age group.

Tardive dyskinesia and the primary psychiatric diagnosis.

Abstract Over 300 patients were assessed for the presence of tardive dyskinesia in relation to the primary psychiatric diagnosis. Patients with organic mental syndrome or bipolar disorder showed a significantly (P

Complications of tardive dyskinesia: A review

Abstract Tardive dyskinesia (TD) is a side effect of neuroleptic treatment. Studies report up to 60% prevalence in chronically treated patients. Although many patients develop only milder forms, its complications present a serious health care problem and also can be misdiagnosed. We propose and describe the following classification: Medical or primary complications at times resemble symptoms of medical illnesses and arise directly from abnormal involuntary movements of a particular muscle group. They include disturbances of gait and posture, gastrointestinal function, speech, and respiration. Psychosocial or secondary complications at times resemble symptoms of psychiatric illnesses and arise indirectly from the general presence of abnormal involuntary movements. They include suicide and possible increased mortality, occupational impairment, and social stigmatization.

Tardive dyskinesia: a two-year follow-up study.

Abstract Eighty patients whose tardive dyskinesia (TD) had been assessed two years previously were reevaluated. The majority (66%) showed no change in their TD. An almost equal number improved (18%) and worsened (16%). Patients whose TD improved were younger (P

Tardive Dyskinesia in the Course of Antidepressant Therapy: A Prevalence Study and Review of the Literature

The authors present a prevalence study of tardive dyskinesia (TD) in the course of antidepressant therapy. Of the 50 patients evaluated, three developed TD. TD developed rapidly and in a short period of time. Withdrawal of antidepressant inproved TD in two patients. The literature on TD developing in the course of antidepressant therapy is reviewed, and the different etiological theories are examined.

A comparison of severe tardive dystonia and severe tardive dyskinesia

The authors present a demographic study comparing tardive dystonia with severe tardive dyskinesia (TD) patients. Tardive dystonia was more common among young men, while severe TD was more common in older women. Neuroleptics were distributed equally in both groups before the onset of the movement disorders. Drug‐free periods were common in the history of severe TD than in tardive dystonia patients.

Carbamazepine in the treatment of aggressive behavior in schizophrenic patients: a case report

Carbamazepine has been used in the treatment of temporal lobe epilepsy since 1963. It has also been found effective in the treatment of psychiatric disorders accompanying epilepsy. Patients with nonspecific EEG abnormalities without overt epilepsy but with behavioral problems, including gross psychopathology and violent behavior, improve on carbamazepine. These findings prompted us to use it in the treatment of aggressive behavior in a schizophrenic patient. Due to the frequency and severity of aggressive behavior in this patient, maintenance ECT was given. However, when carbamazepine was instituted, ECT was discontinued and the patient has been virtually free from aggressive behavior since this medication has been instituted. The authors conclude that carbamazepine may be used in the treatment of aggressive behavior in schizophrenic patients.

The Pisa syndrome (or pleurothotonus): Prevalence in a psychogeriatric population

The present study examines the prevalence of the Pisa syndrome (or pleurothotonus) in newly admitted psychogeriatric patients and compares it with the prevalence of acute dystonia in the same patient population

Tardive dyskinesia in an outpatient population: prevalence and predisposing factors.

One hundred and eighty outpatients at the outpatient services of the Douglas Hospital were evaluated for the presence of tardive dyskinesia. Forty-nine (27%) among them had tardive dyskinesia. In this study, female sex, older age and the current administration of antiparkinsonian medication were found to be significantly related to the occurrence of tardive dyskinesia.