BuKey Terms

Choreathetoid movements—Repetitive dancelike movements that have no rhythm.

Clozapine—A newer antipsychotic medication that is often given to patients who are developing signs of tardive dyskinesia.

Neuroleptic—Another name for the older antipsychotic medications, such as haloperidol (Haldol) and chlorpromazine (Thorazine).

Syndrome—A group of symptoms that together characterize a disease or disorder.

Tardive dyskinesia—A condition that involves involuntary movements of the tongue, jaw, mouth or face or other groups of skeletal muscles that usually occurs either late in antipsychotic therapy or even after the therapy is discontinued. It may be irreversible.

Results

The total score on the AIMS test is not reported to the patient. A rating of 2 or higher on the AIMS scale, however, is evidence of tardive dyskinesia. If the patient has mild TD in two areas or moderate movements in one area, then he or she should be given a diagnosis of TD. The AIMS test is considered extremely reliable when it is given by experienced raters.

If the patient's score on the AIMS test suggests the diagnosis of TD, the clinician must consider whether the patient still needs to be on an antipsychotic medication. This question should be discussed with the patient and his or her family. If the patient requires ongoing treatment with antipsychotic drugs, the dose can often be lowered. A lower dosage should result in a lower level of TD symptoms. Another option is to place the patient on a trial dosage of clozapine (Clozaril), a newer antipsy-chotic medication that has fewer side effects than the older neuroleptics.

See also Medication-induced movement disorders; Schizophrenia

Resources books

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition, text revised. Washington, DC: American Psychiatric Association, 2000.

Blacker, Deborah, M.D., Sc.D. "Psychiatric Rating Scales." In Comprehensive Textbook of Psychiatry, edited by

Benjamin J. Sadock, M.D.and Virginia A. Sadock, M.D. 7th edition. Philadelphia: Lippincott Williams and Wilkins, 2000.

Mischoulon, David and Maurizio Fava. "Diagnostic Rating Scales and Psychiatric Instruments." In Psychiatry Update and Board Preparation, edited by Thomas A. Stern, M.D. and John B. Herman, M.D. New York: McGraw Hill, 2000.

periodicals

Gervin, Maurice, M.R.C. Psych, and others. "Spontaneous Abnormal Involuntary Movements in First-Episode Schizophrenia and Schizophreniform Disorder: Baseline Rate in a Group of Patients From an Irish Catchment Area." American Journal of Psychiatry September 1998: 1202-1206.

Jeste, Dilip V., M.D., and others. "Incidence of Tardive

Dyskinesia in Early Stages of Low Dose Treatment With Typical Neuroleptics in Older Patients." American Journal of Psychiatry February 1999: 309-311.

Ondo, William G., M.D., and others. "Tetrabenazine Treatment for Tardive Dyskinesia: Assessment by Randomized Videotape Protocol." American Journal of Psychiatry August 1999: 1279-1281.

organizations

National Alliance for Research on Schizophrenia and

Depression (NARSAD). 60 Cutter Mill Road, Suite 404, Great Neck, NY 11021. (516) 829-0091. <www.mhsource.com>.

National Institute of Mental Health (NIMH). 6001 Executive Boulevard, Room 8184, Bethesda, MD, 20892-9663. (301) 443-4513. <http://www.nimh.nih.gov>.

Susan Hobbs, M.D.

Was this article helpful?

0 0

Post a comment