Zusammenfassung
Die Behandlung schizophrener Psychosen mit Antipsychotika (AP) geht häufig mit einem erhöhten Risiko für später auftretende antipsychotikaassoziierte Bewegungsstörungen (AIB) einher. Diese Symptome zeigen sehr häufig einen chronischen Verlauf. Das Risiko für das Auftreten von Spätdyskinesien (TD) ist assoziiert mit dem pharmakologischen Wirkprofil eines AP, mit der Behandlungsdauer und mit dem Alter. Diese systematische Übersichtsarbeit fasst die aktuelle Studienlage zu Prävalenz, Risikofaktoren, Präventions- und Therapiemöglichkeiten sowie zur Voraussage von TD bei schizophrenen Psychosen zusammen. Die aktuelle Datenlage zur Behandlung von TD ist sehr heterogen. Für die Therapie von TD gibt es vorläufige Evidenz für eine Reduktion oder ein Absetzen der AP, Umstellung auf Clozapin, Gabe von Benzodiazepinen (Clonazepam) und Behandlung mit vesikulären Monoamintransporter(VMAT2)-Inhibitoren, Ginkgo biloba, Amantadin oder Vitamin E. TD können zwar präzise diagnostiziert, jedoch nicht immer effektiv behandelt werden. Früherkennung und Frühbehandlung von TD können die Prognose und das klinische Outcome günstig beeinflussen.
Abstract
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.
Notes
Zur ausführlichen Darstellung der GMA bei schizophrenen Psychosen sei auf weitere Arbeit [1] in Der Nervenarzt verwiesen.
Diese Wirkstoffe sind in Deutschland derzeit nicht zur Behandlung der TD zugelassen.
Die hier vorgestellten fünf Schritte für den Umgang mit TD bei schizophrenen Psychosen stellen keinesfalls wissenschaftlich validierte Leitlinien zur Behandlung von TD dar. Sie spiegeln vielmehr die aktuelle Datenlage und die klinische Erfahrung der Autoren wider.
Literatur
Hirjak D, Northoff G, Thomann PA, Kubera KM, Wolf RC (2018) Genuine motor phenomena in schizophrenic psychoses: Theoretical background and definition of context. Nervenarzt 89(1):44–50. https://doi.org/10.1007/s00115-017-0375-2
Schonecker M (1957) Paroxysmal dyskinesia as the effect of megaphen. Nervenarzt 28(12):550–553
Dose M (2004) Neuroleptika-induzierte vs. genuine Bewegungsstörungen. In: Jahn T (Hrsg) Bewegungsstörungen bei psychischen Erkrankungen. Springer, Heidelberg, S 29–59
Walther S, Strik W (2012) Motor symptoms and schizophrenia. Neuropsychobiology 66(2):77–92
Peralta V et al (2014) Characterization of the deficit syndrome in drug-naive schizophrenia patients: the role of spontaneous movement disorders and neurological soft signs. Schizophr Bull 40(1):214–224
Fink M (2013) Rediscovering catatonia: the biography of a treatable syndrome. Acta Psychiatr Scand Suppl 127:1–47
Lemke MR (1999) Motor signs of depression. Nervenarzt 70(7):600–612
Peralta V et al (2013) Phenomenological differences between spontaneous and drug-related extrapyramidal syndromes in patients with schizophrenia-spectrum disorders. J Clin Psychopharmacol 33(3):438–440
Hirjak D, Thomann PA, Kubera KM, Wolf ND, Sambataro F, Wolf RC (2015) Motor dysfunction within the schizophrenia-spectrum: a dimensional step towards an underappreciated domain. Schizophr Res 169(1–3):217–233. https://doi.org/10.1016/j.schres.2015.10.022
Hirjak D, Thomann PA, Northoff G, Kubera KM, Wolf RC (2017) Deutsche Version der Northoff Catatonia Rating Scale (NCRS-dv) – Ein validiertes Messinstrument zur Erfassung katatoner Symptome. Nervenarzt 88(7):787–796. https://doi.org/10.1007/s00115-016-0136-7
Hirjak D, Kubera KM, Bienentreu S, Thomann PA, Wolf RC (2018) Antipsychotic-induced motor symptoms in schizophrenic psychoses-Part 1: dystonia, akathisia und parkinsonism. Nervenarzt. https://doi.org/10.1007/s00115-018-0582-5
Hirjak D, Sartorius A, Kubera KM, Wolf RC (2018) Antipsychotic-induced motor symptoms in schizophrenic psychoses-part 2: catatonic symptoms and neuroleptic malignant syndrome. Nervenarzt. https://doi.org/10.1007/s00115-018-0581-6
Carbon M, Hsieh CH, Kane JM, Correll CU (2017) Tardive dyskinesia prevalence in the period of second-generation antipsychotic use: a meta-analysis. J Clin Psychiatry 78(3):e264–e278. https://doi.org/10.4088/JCP.16r10832
Ryu S et al (2015) Tardive dyskinesia and tardive dystonia with second-generation antipsychotics in non-elderly schizophrenic patients unexposed to first-generation antipsychotics: a cross-sectional and retrospective study. J Clin Psychopharmacol 35(1):13–21
Correll CU, Kane JM, Citrome LL (2017) Epidemiology, prevention, and assessment of tardive dyskinesia and advances in treatment. J Clin Psychiatry 78(8):1136–1147
Parksepp M et al (2016) Prevalence of neuroleptic-induced movement disorders: an 8‑year follow-up study in chronic schizophrenia inpatients. Nord J Psychiatry 70(7):498–502
Khot V, Wyatt RJ (1991) Not all that moves is tardive dyskinesia. Am J Psychiatry 148(5):661–666
Mion CC et al (1991) MRI abnormalities in tardive dyskinesia. Psychiatry Res 40(3):157–166
Correll CU (2017) Epidemiology and prevention of tardive dyskinesia. J Clin Psychiatry 78(9):e1426
Schooler NR, Kane JM (1982) Research diagnoses for tardive dyskinesia. Arch Gen Psychiatry 39(4):486–487
van Harten PN (1991) Tardive dystonia: male:female ratio. Br J Psychiatry 159:440
van Harten PN et al (2006) Incidence of tardive dyskinesia and tardive dystonia in African caribbean patients on long-term antipsychotic treatment: the Curacao Extrapyramidal Syndromes Study V. J Clin Psychiatry 67(12):1920–1927
van Harten PN, Kahn RS (1999) Tardive dystonia. Schizophr Bull 25(4):741–748
van Harten PN et al (1996) The prevalence of tardive dystonia, tardive dyskinesia, parkinsonism and akathisia The Curacao Extrapyramidal Syndromes Study: I. Schizophr Res 19(2–3):195–203
D’Abreu A, Akbar U, Friedman JH (2018) Tardive dyskinesia: epidemiology. J Neurol Sci 389:17–20
Rosenheck RA (2007) Evaluating the cost-effectiveness of reduced tardive dyskinesia with second-generation antipsychotics. Br J Psychiatry 191:238–245
Rosenheck RA (2007) Comment on “tardive dyskinesia circa 2006”. Am J Psychiatry 164(1):170 (author reply 170)
Kane JM (2017) Assessing patients for tardive dyskinesia. J Clin Psychiatry 78(9):e1428
Miller DD et al (2008) Extrapyramidal side-effects of antipsychotics in a randomised trial. Br J Psychiatry 193(4):279–288
Woods SW et al (2010) Incidence of tardive dyskinesia with atypical versus conventional antipsychotic medications: a prospective cohort study. J Clin Psychiatry 71(4):463–474
Tegeler J (1989) Klinik der Spätdyskinesien. In: Hippius H, Rüther E, Schmauß M (Hrsg) Katatone und dyskinetische Syndrome. Springer, Heidelberg, S 197–211
Tarsy D (1983) History and definition of tardive dyskinesia. Clin Neuropharmacol 6(2):91–99
Kalverdijk LJ et al (2017) A multi-national comparison of antipsychotic drug use in children and adolescents, 2005–2012. Child Adolesc Psychiatry Ment Health 11:55
Zhu X et al (2018) Comparison of unlicensed and off-label use of Antipsychotics prescribed to child and adolescent psychiatric outpatients for treatment of mental and behavioral disorders with different guidelines: the China food and drug administration versus the FDA. J Child Adolesc Psychopharmacol 28(3):216–224
Deng S et al (2018) Off-label antidepressant prescription in pediatric outpatients based on China Food and Drug Administration and Food and Drug Administration regulations: a Chinese retrospective study. Int Clin Psychopharmacol 33(3):172–179
Bakouni H, Berbiche D, Vasiliadis HM (2017) Off-label use of antipsychotics and associated factors in community living older adults. Aging Ment Health 20:1–8. https://doi.org/10.1080/13607863.2017.1401583
Albert U et al (2016) Role and clinical implications of atypical antipsychotics in anxiety disorders, obsessive-compulsive disorder, trauma-related, and somatic symptom disorders: a systematized review. Int Clin Psychopharmacol 31(5):249–258
Cohen BE et al (2015) Antipsychotic prescriptions in Iraq and Afghanistan veterans with posttraumatic stress disorder in Department of Veterans Affairs healthcare, 2007–2012. J Clin Psychiatry 76(4):406–412
Lucke C et al (2018) Off-label prescription of psychiatric drugs by non-psychiatrist physicians in three general hospitals in Germany. Ann Gen Psychiatry 17:7
Ballesteros J, Gonzalez-Pinto A, Bulbena A (2000) Tardive dyskinesia associated with higher mortality in psychiatric patients: results of a meta-analysis of seven independent studies. J Clin Psychopharmacol 20(2):188–194
Ascher-Svanum H et al (2008) Tardive dyskinesia and the 3‑year course of schizophrenia: results from a large, prospective, naturalistic study. J Clin Psychiatry 69(10):1580–1588
Simpson GM, Lee JH, Zoubok B, Gardos G (1979) A rating scale for tardive dyskinesia. Psychopharmacology 64:171–179
Bhidayasiri R et al (2018) Updating the recommendations for treatment of tardive syndromes: a systematic review of new evidence and practical treatment algorithm. J Neurol Sci 389:67–75
van Harten PN et al (2017) The clinical and prognostic value of motor abnormalities in psychosis, and the importance of instrumental assessment. Neurosci Biobehav Rev 80:476–487
Harris MJ et al (1992) High incidence of tardive dyskinesia in older outpatients on low doses of neuroleptics. Psychopharmacol Bull 28(1):87–92
Caligiuri MP et al (1997) Incidence and risk factors for severe tardive dyskinesia in older patients. Br J Psychiatry 171:148–153
Paulsen JS et al (1996) Risk factors for orofacial and limbtruncal tardive dyskinesia in older patients: a prospective longitudinal study. Psychopharmacology (Berl) 123(4):307–314
Jeste DV et al (1995) Risk of tardive dyskinesia in older patients. A prospective longitudinal study of 266 outpatients. Arch Gen Psychiatry 52(9):756–765
Rogers D (1991) Catatonia: a contemporary approach. J Neuropsychiatry Clin Neurosci 3(3):334–340
Francis A et al (2010) Catatonia in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. J Ect 26(4):246–247
Northoff G (2000) Brain imaging in catatonia: current findings and a pathophysiologic model. Cns Spectr 5(7):34–46
Northoff G (2002) What catatonia can tell us about “top-down modulation”: a neuropsychiatric hypothesis. Behav Brain Sci 25(5):555–577 (discussion 578–604)
Solmi M et al (2018) Clinical risk factors for the development of tardive dyskinesia. J Neurol Sci 389:21–27
Chouinard G, Margolese HC (2005) Manual for the Extrapyramidal Symptom Rating Scale (ESRS). Schizophr Res 76(2–3):247–265
Simpson GM, Angus JW (1970) A rating scale for extrapyramidal side effects. Acta Psychiatr Scand Suppl 212:11–19
Caligiuri MP et al (1995) Fluctuation of tardive dyskinesia. Biol Psychiatry 38(5):336–339
Caligiuri MP et al (1991) Clinical and instrumental assessment of neuroleptic-induced parkinsonism in patients with tardive dyskinesia. Biol Psychiatry 29(2):139–148
Caligiuri MP et al (2015) A quantitative measure of handwriting dysfluency for assessing tardive dyskinesia. J Clin Psychopharmacol 35(2):168–174
Caligiuri MP et al (1997) Reliability of an instrumental assessment of tardive dyskinesia: results from VA Cooperative Study #394. Psychopharmacology (Berl) 132(1):61–66
Dean DJ et al (2013) Handwriting analysis indicates spontaneous dyskinesias in neuroleptic naive adolescents at high risk for psychosis. J Vis Exp 81:e50852
Caligiuri MP et al (2009) Handwriting movement analyses for monitoring drug-induced motor side effects in schizophrenia patients treated with risperidone. Hum Mov Sci 28(5):633–642
Caligiuri MP et al (2010) Handwriting movement kinematics for quantifying extrapyramidal side effects in patients treated with atypical antipsychotics. Psychiatry Res 177(1–2):77–83
Caligiuri MP et al (2006) Quantitative measurement of handwriting in the assessment of drug-induced parkinsonism. Hum Mov Sci 25(4–5):510–522
Bergman H et al (2018) Antipsychotic reduction and/or cessation and antipsychotics as specific treatments for tardive dyskinesia. Cochrane Database Syst Rev 2:CD459
Bergman H et al (2017) Systematic review of interventions for treating or preventing antipsychotic-induced tardive dyskinesia. Health Technol Assess 21(43):1–218
Kane JM et al (1983) Low-dose neuroleptic treatment of outpatient schizophrenics. I. Preliminary results for relapse rates. Arch Gen Psychiatry 40(8):893–896
Cookson IB (1987) The effects of a 50 % reduction of cis(z)-flupenthixol decanoate in chronic schizophrenic patients maintained on a high dose regime. Int Clin Psychopharmacol 2(2):141–149
Casey DE, Toenniessen LM (1983) Neuroleptic treatment in tardive dyskinesia: can it be developed into a clinical strategy for long-term treatment? Mod Probl Pharmacopsychiatry 21:65–79
Koshino Y et al (1991) A long-term outcome study of tardive dyskinesia in patients on antipsychotic medication. Clin Neuropharmacol 14(6):537–546
Yassa R, Nair NP (1992) A 10-year follow-up study of tardive dyskinesia. Acta Psychiatr Scand 86(4):262–266
Yassa R, Nair V, Schwartz G (1984) Tardive dyskinesia: a two-year follow-up study. Psychosomatics 25(11):852–855
Chouinard G (1995) Effects of risperidone in tardive dyskinesia: an analysis of the Canadian multicenter risperidone study. J Clin Psychopharmacol 15(Suppl 1):36S–44S
Bai YM, Yu SC, Lin CC (2003) Risperidone for severe tardive dyskinesia: a 12-week randomized, double-blind, placebo-controlled study. J Clin Psychiatry 64(11):1342–1348
Jeste DV et al (1999) Lower incidence of tardive dyskinesia with risperidone compared with haloperidol in older patients. J Am Geriatr Soc 47(6):716–719
Bai YM et al (2005) Risperidone for pre-existing severe tardive dyskinesia: a 48-week prospective follow-up study. Int Clin Psychopharmacol 20(2):79–85
Chen JY et al (2001) Risperidone for tardive dyskinesia. Am J Psychiatry 158(11):1931–1932
Huang CC (1986) Comparison of two groups of tardive dyskinesia patients. Psychiatry Res 19(4):335–336
Peselow ED, Angrist BM, Rotrosen J (1989) Changes in tardive dyskinesia after fluphenazine decanoate discontinuation. Ann Clin Psychiatry 1:187–191
Yagi G, Itoh H (1985) A 10-year follow-up study of tardive dyskinesia—with special reference to the influence of neuroleptic administration on the long-term prognosis. Keio J Med 34(4):211–219
Grover S et al (2014) Management of tardive syndromes with clozapine: a case series. Asian J Psychiatr 8:111–114
Hazari N, Kate N, Grover S (2013) Clozapine and tardive movement disorders: a review. Asian J Psychiatr 6(6):439–451
Joe S et al (2015) Remission of irreversible aripiprazole-induced tardive dystonia with clozapine: a case report. BMC Psychiatry 15:253
Tamminga CA et al (1994) Clozapine in tardive dyskinesia: observations from human and animal model studies. J Clin Psychiatry 55(Suppl B):102–106
Emsley R et al (2004) A single-blind, randomized trial comparing quetiapine and haloperidol in the treatment of tardive dyskinesia. J Clin Psychiatry 65(5):696–701
Chan HY et al (2010) A randomized controlled trial of risperidone and olanzapine for schizophrenic patients with neuroleptic-induced tardive dyskinesia. J Clin Psychiatry 71(9):1226–1233
Caroff SN et al (2011) Treatment outcomes of patients with tardive dyskinesia and chronic schizophrenia. J Clin Psychiatry 72(3):295–303
Cho CH, Lee HJ (2013) Oxidative stress and tardive dyskinesia: pharmacogenetic evidence. Prog Neuropsychopharmacol Biol Psychiatry 46:207–213
Margolese HC et al (2005) Tardive dyskinesia in the era of typical and atypical antipsychotics. Part 1: pathophysiology and mechanisms of induction. Can J Psychiatry 50(9):541–547
Margolese HC et al (2005) Tardive dyskinesia in the era of typical and atypical antipsychotics. Part 2: Incidence and management strategies in patients with schizophrenia. Can J Psychiatry 50(11):703–714
Stahl SM (2018) Mechanism of action of vesicular monoamine transporter 2 (VMAT2) inhibitors in tardive dyskinesia: Reducing dopamine leads to less “go” and more “stop” from the motor striatum for robust therapeutic effects. Cns Spectr 23(1):1–6
Asher SW, Aminoff MJ (1981) Tetrabenazine and movement disorders. Neurology 31(8):1051–1054
Ondo WG, Hanna PA, Jankovic J (1999) Tetrabenazine treatment for tardive dyskinesia: assessment by randomized videotape protocol. Am J Psychiatry 156(8):1279–1281
Hauser RA et al (2017) KINECT 3: a phase 3 randomized, double-blind, placebo-controlled trial of valbenazine for tardive dyskinesia. Am J Psychiatry 174(5):476–484
O’Brien CF et al (2015) NBI-98854, a selective monoamine transport inhibitor for the treatment of tardive dyskinesia: a randomized, double-blind, placebo-controlled study. Mov Disord 30(12):1681–1687
Kane JM et al (2017) Efficacy of valbenazine (NBI-98854) in treating subjects with tardive dyskinesia and schizophrenia or schizoaffective disorder. Psychopharmacol Bull 47(3):69–76
El-Sayeh HG et al (2018) Non-antipsychotic catecholaminergic drugs for antipsychotic-induced tardive dyskinesia. Cochrane Database Syst Rev 1:CD458
Bergman H, Bhoopathi PS, Soares-Weiser K (2018) Benzodiazepines for antipsychotic-induced tardive dyskinesia. Cochrane Database Syst Rev 1:CD205
Cassano R et al (2017) Alpha-Tocopheryl linolenate solid lipid nanoparticles for the encapsulation, protection, and release of the omega-3 polyunsaturated fatty acid: in vitro anti-melanoma activity evaluation. Colloids Surf B Biointerfaces 151:128–133
Miller R, Chouinard G (1993) Loss of striatal cholinergic neurons as a basis for tardive and L‑dopa-induced dyskinesias, neuroleptic-induced supersensitivity psychosis and refractory schizophrenia. Biol Psychiatry 34(10):713–738
Burnett GB et al (1980) Adverse effects of anticholinergic antiparkinsonian drugs in tardive dyskinesia. An investigation of mechanism. Neuropsychobiology 6(2):109–120
Chouinard G, Steinberg S (1982) Type I tardive dyskinesia induced by anticholinergic drugs, dopamine agonists and neuroleptics. Prog Neuropsychopharmacol Biol Psychiatry 6(4–6):571–578
Gardos G, Cole JO (1983) Tardive dyskinesia and anticholinergic drugs. Am J Psychiatry 140(2):200–202
Klawans HL, Rubovits R (1974) Effect of cholinergic and anticholinergic agents on tardive dyskinesia. J Neurol Neurosurg Psychiatry 37(8):941–947
Tammenmaa-Aho I et al (2018) Cholinergic medication for antipsychotic-induced tardive dyskinesia. Cochrane Database Syst Rev 3:CD207
Bergman H, Soares-Weiser K (2018) Anticholinergic medication for antipsychotic-induced tardive dyskinesia. Cochrane Database Syst Rev 1:CD204
Angus S et al (1997) A controlled trial of amantadine hydrochloride and neuroleptics in the treatment of tardive dyskinesia. J Clin Psychopharmacol 17(2):88–91
Ankenman R (1989) The combination of amantadine and neuroleptics plus time may cure tardive dyskinesia. J Neuropsychiatry Clin Neurosci 1(1):96–97
Freudenreich O, McEvoy JP (1995) Added amantadine may diminish tardive dyskinesia in patients requiring continued neuroleptics. J Clin Psychiatry 56(4):173
Pappa S et al (2010) Effects of amantadine on tardive dyskinesia: a randomized, double-blind, placebo-controlled study. Clin Neuropharmacol 33(6):271–275
Silver H, Geraisy N, Schwartz M (1995) No difference in the effect of biperiden and amantadine on parkinsonian- and tardive dyskinesia-type involuntary movements: a double-blind crossover, placebo-controlled study in medicated chronic schizophrenic patients. J Clin Psychiatry 56(4):167–170
Dinan TG, Kohen D (1989) Tardive dyskinesia in bipolar affective disorder: relationship to lithium therapy. Br J Psychiatry 155:55–57
Jus A et al (1978) Deanol, lithium and placebo in the treatment of tardive dyskinesia. A double-blind crossover study. Neuropsychobiology 4(3):140–149
Reda FA, Escobar JI, Scanlan JM (1975) Lithium carbonate in the treatment of tardive dyskinesia. Am J Psychiatry 132(5):560–562
van Harten PN et al (2008) Evidence that lithium protects against tardive dyskinesia: the Curacao Extrapyramidal Syndromes Study VI. Eur Neuropsychopharmacol 18(2):152–155
Soares-Weiser K, Maayan N, Bergman H (2018) Vitamin E for antipsychotic-induced tardive dyskinesia. Cochrane Database Syst Rev 1:CD209
Adelufosi AO, Abayomi O, Ojo TM (2015) Pyridoxal 5 phosphate for neuroleptic-induced tardive dyskinesia. Cochrane Database Syst Rev 4:CD10501
Niemann N, Jankovic J (2018) Treatment of Tardive Dyskinesia: A General Overview with Focus on the Vesicular Monoamine Transporter 2 Inhibitors. Drugs 78(5):525–541
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D. Hirjak, K.M. Kubera, S. Bienentreu, P.A. Thomann und R.C. Wolf geben an, dass kein Interessenkonflikt besteht.
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Hirjak, D., Kubera, K.M., Bienentreu, S. et al. Antipsychotikaassoziierte motorische Symptome bei schizophrenen Psychosen – Teil 3. Nervenarzt 90, 472–484 (2019). https://doi.org/10.1007/s00115-018-0629-7
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DOI: https://doi.org/10.1007/s00115-018-0629-7