Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two iatrogenic effects of antipsychotic medications other than tardive dyskinesia have been recently described in schizophrenic populations: akinesia and tardive dysmentia. These effects involve activational, cognitive, and affective rather than motor changes, and closely resemble two most common prefrontal syndromes: dorsolateral and fronto-orbital/mediobasal. It is possible that the widely reported "frontal lobe dysfunction" in some chronic schizophrenic patients at least in part reflects iatrogenic changes in the mesolimbic/mesocortical dopamine system, which projects extensively into prefrontal areas. The degree of iatrogenic versus genuine contribution to the frontal lobe dysfunction in schizophrenia needs to be ascertained further, and the heterogeneity of known frontal lobe syndromes must be taken into account in describing schizophrenic populations. The mechanisms of noniatrogenic contributions to the frontal lobe dysfunction in schizophrenia may reflect a variety of anatomical sources and require further examination.
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PMID:Akinesia, tardive dysmentia, and frontal lobe disorder in schizophrenia. 286 56

Of 99 consecutive male patients studied at the North Chicago VA Tardive Dyskinesia Program, 58 had tardive dyskinesia and 41 did not. Factors that were significantly related, singly and in combinations, to tardive dyskinesia were 1) diagnosis of affective disorder with alcoholism and/or drug-induced parkinsonism, and 2) diagnosis of schizophrenia with advanced age (over 50) and/or prolonged hospitalization (over 14 years). A diagnosis of schizophrenia in patients under age 50 with short hospitalizations was not significantly associated with the presence of tardive dyskinesia.
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PMID:Vulnerability to tardive dyskinesia. 286 57

Functional supersensitivity of mesolimbic and striatal dopamine receptors has been suggested to contribute to the pathogenesis of schizophrenia and tardive dyskinesia. Using the rodent model of chronic administration of the neuroleptic haloperidol, we investigated the possible desensitizing effects of a tripeptide structurally unrelated to dopamine agonists, L-prolyl-L-leucyl-glycinamide (PLG) on mesolimbic and striatal dopaminergic receptor supersensitivity. Administration of PLG either prior to or after chronic haloperidol, inhibited the supersensitivity of dopamine receptors. The results have implications for pharmacological intervention in preventing tardive dyskinesia and relapse psychosis of schizophrenia.
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PMID:Mesolimbic and striatal dopamine receptor supersensitivity: prophylactic and reversal effects of L-prolyl-L-leucyl-glycinamide (PLG). 286 9

A program of routine Abnormal Involuntary Movement Scale (AIMS) examinations is contrasted with a referral system for detection of tardive dyskinesia in an outpatient schizophrenia clinic. Routine clinical use of the AIMS examination may have improved the early detection of tardive dyskinesia, which could result in a decrease in the morbidity associated with this disorder. Routine AIMS examinations also facilitated repeat discussions with patients about tardive dyskinesia, which provide an opportunity to obtain ongoing informed consent for treatment with neuroleptics.
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PMID:Screening for tardive dyskinesia. 286 94

Long-acting depot neuroleptics are likely to receive increasing consideration in the maintenance treatment of schizophrenia because of the growing recognition of noncompliance with daily oral medication in this patient population. The impending availability of haloperidol decanoate in the United States may also increase the use of long-acting neuroleptics. The long-term safety of these drugs, therefore, deserves close scrutiny. Based on experiences with other depot neuroleptics, the safety profile of haloperidol decanoate is unlikely to differ from short-acting formulations of haloperidol. In general, tardive dyskinesia remains the most troubling problem associated with long-term neuroleptic treatment. The available information indicates that all neuroleptics, including long-acting preparations, share the same propensity for causing tardive dyskinesia. Furthermore, the use of the lowest effective dose of a neuroleptic appears to minimize the severity of tardive dyskinesia should it develop. Extrapyramidal symptoms, notably akinesia and akathisia, are also potential concerns of maintenance treatment with oral and depot neuroleptics; however, the occurrence of these side effects appears dose related. Thus, the clinician can favorably influence the benefit-to-risk ratio of long-acting depot neuroleptics by minimizing potential side effects through the use of a low dose strategy.
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PMID:Depot neuroleptics: side effects and safety. 287 89

Psychiatry's response to the risk of tardive dyskinesia (TD) from long-term neuroleptic drug use continues to swing from one extreme (overreaction) to the other (minimization or denial). The potential negative effects on psychiatric practice of these extreme responses are reviewed. We suggest that while concerns about litigation may partially account for the continued overreaction and minimization, a more fundamental explanation is psychiatry's continuing inability to integrate itself fully as a medical discipline. We suggest that four basic concepts about schizophrenia and its long-term treatment need to be accepted before TD can be responded to objectively: schizophrenia is a serious brain disease; neuroleptics are helpful when properly used; there are limits to the value of neuroleptic drugs in the treatment of schizophrenia; and neuroleptic drugs can cause serious side effects.
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PMID:Minimization and overreaction to tardive dyskinesia. 287 21

Tardive dyskinesia (TD), a possible marker of the defect state of schizophrenia, was studied along with defect symptoms in 55 neuroleptic-treated chronic schizophrenic patients. Our cross-sectional data failed to replicate earlier findings of increased defect symptoms in TD patients (n = 14), except for more severe paucity of speech content when compared with non-TD patients (n = 41). Methodological issues that may account for some of the current and previously reported findings are discussed.
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PMID:Defect symptoms and abnormal involuntary movement in schizophrenia. 287 45

This article reviews the 1980's literature on gender differences in schizophrenia outcome. Neuroleptic response, long-term course, and housing, appear to be superior in women. Mortality ratios are advantageous to schizophrenic men. After menopause, women may require higher neuroleptic doses than men and are more at risk for severe tardive dyskinesia. The antidopaminergic effects of estrogens appear to be responsible for some of the outcome differences.
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PMID:Current outcome in schizophrenia: women vs men. 287 10

Factors associated with the emergence or nonemergence of involuntary movements (tardive dyskinesia) during long-term neuroleptic treatment were investigated in an atypical, isolated population of 31 schizophrenic inpatients with an unusually high prevalence of this syndrome. Patients with involuntary movements could not be distinguished from those without such movements by general characteristics or conventional indices of neuroleptic or anticholinergic treatment. However, they were more likely to show either marked cognitive dysfunction or muteness. These findings support the proposal that, at least in schizophrenia, subtle organic changes may contribute to vulnerability to the emergence of involuntary movements.
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PMID:An unusual cluster of tardive dyskinesia in schizophrenia: association with cognitive dysfunction and negative symptoms. 287 64

Neuroleptic drugs are of proven value in schizophrenia for both the treatment of acute psychotic states and for the prevention of relapse in patients who have recovered from psychosis. However, these drugs have a number of important limitations: they are not effective for all patients, they have a number of serious adverse effects, and they are limited in what they can do. Some of the more serious side effects, particular tardive dyskinesia, require that clinicians use these drugs only in situations when they are demonstrably effective, and at the lowest effective dose. For most schizophrenic patients, neuroleptics should be only one part of a treatment program which will also include appropriate psychosocial treatment.
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PMID:Benefits and limitations of neuroleptics--and other forms of treatment--in schizophrenia. 287 53


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