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Related: About this forumGreybnk48
(10,176 posts)matt819
(10,749 posts)The usual comments aside, what does the jaw moving side to side mean?
reeds2012
(91 posts)frogmarch
(12,158 posts)simple motor tic. I don't think it means much. Several people I know have tics. Maybe I have one (or more) too.
leveymg
(36,418 posts)PMCID: PMC2730062
Aripiprazole (Abilify) and Tardive Dyskinesia
Thomas Schwartz, MD and Shafi Raza, MD
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Abstract
Second-generation (atypical) antipsychotic agents are being used within their indications as well as widely off-label because of their lower risk of causing extrapyramidal symptoms and tardive dyskinesia (TD). The risk of metabolic disorders has taken over much of clinical practice and the current literature on adverse effects. In this brief article, we discuss a case of TD that developed after a patient used aripiprazole as off-label augmentation for treatment-resistant depression. We emphasize the fact that TD is an adverse effect that must still be monitored.
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INTRODUCTION
Tardive dyskinesia (TD) is usually a late-developing, well-known neuromuscular adverse effect associated with the long-term use of first-generation (typical or conventional) anti-psychotic agents, such as chlorpromazine (Thorazine, Glaxo-SmithKline), haloperidol (Haldol, Ortho-McNeil), and fluphenazine (Prolixin, Apothecon). After months to years of therapy with dopamine-2 (D2) receptorblockers, patients often experience involuntary choreiform, athetotic, or ballismic dyskinetic movements. These movements most commonly involve the mouth, tongue, facial muscles, and upper extremities. Axial dyskinesias may also occur.1
With the advent of the second-generation (atypical) anti-psychotic agents (SGAs), all of which utilize a serotonin-2 receptor (5-HT2) blockade, the risk of TD has apparently decreased, thereby allowing clinicians to treat schizophrenia with less possibility of a side-effect burden. Given this fact and the potential of these agents to treat several targeted symptoms (i.e., cognition, dysphoria, mania, and agitation), pharmaceutical companies have proceeded with studies and have gained approvals from the Food and Drug Administration (FDA) for most SGAs in areas other than schizophrenia, such as bipolar mania and depression and, in the case of risperidone (Risperdal, Janssen), autism.2,3 The off-label use of SGAs also continues to increase in the form of augmented therapies for resistant depression and anxiety.4,5 In fact, the FDA recently approved aripiprazole as the first augmentation (add-on) strategy for the treatment of unipolar major depression.
This article presents the case of a patient with treatment-resistant depression who experienced TD during augmentation therapy with aripiprazole (Abilify, Bristol-Myers Squibb/ Otsuka). Aripiprazole may be considered an atypical atypical agent; it is a partial dopamine agonist, not a full antagonist. Its unique profile allows for subtle increases in tonic dopamine neuron firing rates in brain areas that are hypofunctioning and for dampening of dopaminergic activity in areas that are hyperfunctioning. This blockade of hyperdominergic regions in the brain is thought to alleviate psychosis.
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RISK FACTORS FOR TARDIVE DYSKINESIA
Typical risk factors associated with the development of TD include older age, pre-existing movement or neurodegenerative disorders, female sex, the presence of affective illness, and neuroleptic exposure of more than six months.6 The use of higher-potency, first-generation agents is also more likely to increase the risk of TD and extrapyramidal symptoms (EPS). There is little doubt that conventional antipsychotic agents, compared with SGAs, are more likely to cause TD. However, among the SGAs currently available, those with more transient D2 receptor blockade and lower D2 affinity, such as quetiapine (Seroquel, AstraZeneca), are associated with the smallest risk, at least for EPS and probably TD.
At a therapeutic dose, it is noteworthy that aripiprazole has one of the highest D2 receptor affinities; however, because of its partial agonist properties, it has a lower risk of causing acute EPS and, probably, TD.710 A timely study of exposure to antipsychotic drugs in nongeriatric adults suggests that the incidence of TD with SGAs is 0.8%, compared with 5.4% with haloperidol, a high-potency, first-generation antipsychotic agent.11
Spitfire of ATJ
(32,723 posts)[img][/img]
MADem
(135,425 posts)Bainbridge Bear
(155 posts)that this sociopath was installed as President and then "elected" for a second term. He was an unmitigated disaster for most of the citizens of this country. His premeditated invasion of Iraq may go down as our greatest foreign policy blunder and the Nobel Prize-winning economist Joseph Stiglitz said the other day that the Iraq and Pakistan "wars" brought on the Great Recession. If there is any justice George W. Bush will go down as the worst president in U.S. history. I can still barely look at him without feeling revulsion.
DhhD
(4,695 posts)Next speech, he seemed to be less effected. This is what I saw on television. Does anybody have some close-up video?
Rob H.
(5,352 posts)Welcome to DU, too, btw.
There was also another tic when Shrub (finally) went to New Orleans after Katrina and gave a speech--he'd say a few words, stick just the tip of his tongue out of his mouth, and then continue speaking. I remember watching the speech and keeping a running tally of how many times he did it: 11 instances of Swiv-O-Mandible, but more than 40 times with the lizard tongue tic. It was bizarre!
Further edit: it was actually more recent than that--it was one of his State of the Union addresses. Oops!
reeds2012
(91 posts)and this jaw tic was getting very repetitive. He started to purse his lips together a lot around that time to try to control it. Supplant one tic with another!
Lint Head
(15,064 posts)Hubert Flottz
(37,726 posts)Edit...He's keeping his jaws in shape so he can keep on lying 24/7.
lumpy
(13,704 posts)Ugly
Plucketeer
(12,882 posts)needs to hurry up and join Reagan in Hades Diablo's gonna have quite a welcome home party for this advocate!
reeds2012
(91 posts)* Central nervous system and psychiatric effects: Users who have pleasurable experiences report varying degrees of euphoria; increased energy, excitement, and sociability; less hunger and fatigue; a marked feeling of increased physical and mental strength; and decreased sensation of pain. Some will feel a great sense of power and competence that may be associated with the delusion or false sense of grandeur, known as cocainomania. There can be talkativeness, good humor, and laughing. Dilated pupils, nausea, vomiting, headache, or vertigo (the sensation of your surroundings or yourself moving or spinning). With or even without increased amounts of coke, these can progress to excitement, flightiness, emotional instability, restlessness, irritability, apprehension, inability to sit still, teeth grinding, cold sweats, tremors, twitching of small muscles (especially of face, fingers, feet), muscle jerks, hallucinations (cocaine bugs, snow lights, voices and sounds, smells), and cocaine psychosis. Cocaine psychosis resembles paranoid schizophrenia and can bring on paranoia, mania, and psychosis.
http://www.emedicinehealth.com/cocaine_abuse/article_em.htm
HopeHoops
(47,675 posts)bitchkitty
(7,349 posts)So do cokeheads. Not surprised at all.