These neuropsychiatric manifestations are often under-recognized and under-treated, yet they negatively affect daily functioning and overall well-being of PD patients 48,49,50
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Drugs classified as second-generation antipsychotics (SGAs) have consistently shown a reduced risk of TD compared with first-generation antipsychotics (FGAs).Reference Carbon, Hsieh, Kane and Correll 36 , Reference Carbon, Kane, Leucht and Correll 37 , Reference Casey 56 , Reference Correll, Leucht and Kane 66 - Reference Tenback, van Harten, Slooff, Belger and van Os 68 The true risk differential may not be as great as initially thought, ranging from one-quarter to two-thirds of the risk of FGAs.Reference Patterson-Lomba, Ayyagari and Carroll 47 , Reference Woods, Morgenstern and Saksa 69 - Reference Miller, Caroff and Davis 72 Several meta-analyses have shown that relative risk may have more to do with D2-receptor blocking potency of individual antipsychotics rather than the year a drug was introduced.Reference Correll and Schenk 73 , Reference Leucht, Wahlbeck, Hamann and Kissling 74 Patients receiving higher cumulative doses for longer duration are intuitively at greater risk,Reference Patterson-Lomba, Ayyagari and Carroll 47 , Reference Casey 56 , Reference Kane, Rifkin and Woerner 75 although clinicians should remain vigilant given that even short-term treatment with low doses may induce TD in vulnerable patients.Reference Zichlin, Mu, Leo and Ayyagari 76 So, for example, prolonged high doses of haloperidol predictably cause TD, whereas the risk of TD with clozapine is significantly diminished.Reference Woods, Morgenstern and Saksa 69 , Reference Kane, Woerner, Pollack, Safferman and Lieberman 77 The relative risk of long-acting injectable antipsychotics compared to oral agents is unclear but likely similar, with newer SGAs less likely than FGAs to cause TD in some but not all studies.Reference Kannarkat, Morley and Caroff 78 - Reference Saucedo Uribe, Carranza Navarro and Guerrero Medrano 81 Studies of long-acting injectable agents have suggested that guaranteed continuous administration of antipsychotics may actually decrease the risk of TD compared with intermittent treatment resulting from drug holidays, symptom-driven administration or patient nonadherence.Reference Jeste and Wyatt 82 - Reference Hogarty, Schooler, Ulrich, Mussare, Ferro and Herron 85 The effect of other prescription drugs or substance abuse on the risk of TD is less clear
In: Soloneski S, Larramendy M (eds)
