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What Causes Tardive Dyskinesia?
Question: Okay. Lets say a patient takes a first generation high potency phenothiazine antipsychotic such as flupheanazine (Prolixin) at only 12.5 mg I.M. every two weeks. 2mg Cogentin daily is added after the first two weeks. Since this is the patient's first episode the drug is discontinued after six weeks. The patient feels he/she can no longer tolerate the EPS side effects. Three months after the drug is discontinued the tardive dyskinesia goes away. The same patient goes medicated for three years and has been evaluated by two other doctors as not requiring any medication. As you know this drug like thiothixene and haloperidol are graded as "four stars" for causing EPS symptoms on a scale of 0-4 stars unlike most second generation antipsychotics.....except for lurasidone (Latuda.) Three sources tell me that Latuda gives "four stars" for EPS symptoms. The same patient is now sick again and has been stabalized on 80mg of Latuda for four years. Finally the question: How come that same patient never gets tardive dyskinesia even though he/she gets akathesia for the first a few weeks? ....even after four years?
Mistake in one of the paragraphs: ......The same patient goes UNMEDICATED for three years.....Sorry!
Mistake in one of the paragraphs: ......The same patient goes UNMEDICATED for three years.....Sorry!
Brief Answer:
The risk is relatively lower with Latuda.
Detailed Answer:
Hello thanks for asking from HCM for your health related queries
I can understand your concern. Tardive Dyskinesia or TD is a side effect seen after long term use of antipsychotic drug. TD is an irreversible side effect and is very difficult to treat fully. The drugs with highest action on D2 receptors are known to have high risk of TD as compared to newer drugs.
Exact mechanism why TD occurs is not well known. A lot of patients with long standing antipsychotic treatment doesn't develop TD while others develop. So we can't predict which patient will develop TD. Occurrence of Akithesia as side effect doesn't mean that patient will definitely develop TD. Akathesia and TD are not related.
In my experience and also based upon studies Latuda has relatively lower propensity to cause TD.
So, since patient is on Latuda for four years and the risk of TD is relatively low with Latuda the patient never get TD. Akathesia is not related with TD. So even if a patient developed akathesia with Latuda that doesn't mean that he will develop TD.
Thanks, I hope this clears your doubt. Please don't hesitate to ask again for more doubts. Take care
The risk is relatively lower with Latuda.
Detailed Answer:
Hello thanks for asking from HCM for your health related queries
I can understand your concern. Tardive Dyskinesia or TD is a side effect seen after long term use of antipsychotic drug. TD is an irreversible side effect and is very difficult to treat fully. The drugs with highest action on D2 receptors are known to have high risk of TD as compared to newer drugs.
Exact mechanism why TD occurs is not well known. A lot of patients with long standing antipsychotic treatment doesn't develop TD while others develop. So we can't predict which patient will develop TD. Occurrence of Akithesia as side effect doesn't mean that patient will definitely develop TD. Akathesia and TD are not related.
In my experience and also based upon studies Latuda has relatively lower propensity to cause TD.
So, since patient is on Latuda for four years and the risk of TD is relatively low with Latuda the patient never get TD. Akathesia is not related with TD. So even if a patient developed akathesia with Latuda that doesn't mean that he will develop TD.
Thanks, I hope this clears your doubt. Please don't hesitate to ask again for more doubts. Take care
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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