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Tardive Dyskinesia Causes / At Risk Medications
Tardive Dyskinesia is a serious neurological disorder caused by the long-term and/or high-dose use of dopamine antagonists, usually antipsychotics and among them especially the typical antipsychotics. These neuroleptic drugs are generally prescribed for serious psychiatric disorders. The older typical antipsychotics, which appear to cause tardive dyskinesia somewhat more often than the newer atypical antipsychotics, are being prescribed less frequently. There are some new uses, however, such as year-long implants that are being developed using the older typical antipsychotic's, e.g., Haldol, one of the worst offenders when it comes to tardive dyskinesia.
Other dopamine antagonists that can cause tardive dyskinesia are drugs for gastrointestinal disorders such as Reglan – metoclopramide. Some drugs that are not intended to affect dopamine, such as SSRI antidepressants, e.g., Paxil, Zoloft, Lexapro, and Celexa, may also cause tardive dyskinesia. The new generation of atypical antipsychotics, e.g., Risperdal (Risperidone), Zyprexa (Olanzapine), Seroquel (Quetiapine), Geodon (Ziprasidone), and Abilify (Aripiprazole), appear to cause tardive dyskinesia somewhat less frequently (though they may cause serious metabolic disorders such as hyperglycemia and diabetes, frequently enough to make them equally dangerous).
The cause of tardive dyskinesia appears to be related to damage — due to the use of antipsychotic medications or the dopamine antagonist drug such as Reglan — to the system that uses and processes the neurotransmitter dopamine. It is thought that postsynaptic dopaminergic receptors become supersensitive to stimulation during neuroleptic treatment and that this supersensitivity causes the symptoms of tardive dyskinesia.
The available research seems to suggest that the concurrent prophylactic use of a neuroleptic and an antiparkinsonian drug is useless to avoid early extrapyramidal side-effects and may render the patient more sensitive to tardive dyskinesia.
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