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[PMID]:28454738
[Au] Autor:Miksys S; Wadji FB; Tolledo EC; Remington G; Nobrega JN; Tyndale RF
[Ad] Endereço:Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Canada; Department of Pharmacology and Toxicology, University of Toronto, Canada. Electronic address: s.miksys@utoronto.ca.
[Ti] Título:Rat brain CYP2D enzymatic metabolism alters acute and chronic haloperidol side-effects by different mechanisms.
[So] Source:Prog Neuropsychopharmacol Biol Psychiatry;78:140-148, 2017 Aug 01.
[Is] ISSN:1878-4216
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Risk for side-effects after acute (e.g. parkinsonism) or chronic (e.g. tardive dyskinesia) treatment with antipsychotics, including haloperidol, varies substantially among people. CYP2D can metabolize many antipsychotics and variable brain CYP2D metabolism can influence local drug and metabolite levels sufficiently to alter behavioral responses. Here we investigated a role for brain CYP2D in acutely and chronically administered haloperidol levels and side-effects in a rat model. Rat brain, but not liver, CYP2D activity was irreversibly inhibited with intracerebral propranolol and/or induced by seven days of subcutaneous nicotine pre-treatment. The role of variable brain CYP2D was investigated in rat models of acute (catalepsy) and chronic (vacuous chewing movements, VCMs) haloperidol side-effects. Selective inhibition and induction of brain, but not liver, CYP2D decreased and increased catalepsy after acute haloperidol, respectively. Catalepsy correlated with brain, but not hepatic, CYP2D enzyme activity. Inhibition of brain CYP2D increased VCMs after chronic haloperidol; VCMs correlated with brain, but not hepatic, CYP2D activity, haloperidol levels and lipid peroxidation. Baseline measures, hepatic CYP2D activity and plasma haloperidol levels were unchanged by brain CYP2D manipulations. Variable rat brain CYP2D alters side-effects from acute and chronic haloperidol in opposite directions; catalepsy appears to be enhanced by a brain CYP2D-derived metabolite while the parent haloperidol likely causes VCMs. These data provide novel mechanistic evidence for brain CYP2D altering side-effects of haloperidol and other antipsychotics metabolized by CYP2D, suggesting that variation in human brain CYP2D may be a risk factor for antipsychotic side-effects.
[Mh] Termos MeSH primário: Encéfalo/efeitos dos fármacos
Encéfalo/enzimologia
Família 2 do Citocromo P450/metabolismo
Haloperidol/efeitos adversos
[Mh] Termos MeSH secundário: Animais
Encéfalo/metabolismo
Catalepsia/induzido quimicamente
Haloperidol/sangue
Fígado/enzimologia
Masculino
Microinjeções
Nicotina/administração & dosagem
Nicotina/farmacologia
Propranolol/administração & dosagem
Propranolol/farmacologia
Ratos
Discinesia Tardia/induzido quimicamente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
6M3C89ZY6R (Nicotine); 9Y8NXQ24VQ (Propranolol); EC 1.14.14.1 (Cytochrome P450 Family 2); J6292F8L3D (Haloperidol)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:29338466
[Au] Autor:Sarva H; Henchcliffe C
[Ad] Endereço:a Parkinson's Disease and Movement Disorders Institute , Weill Cornell Medicine/New York Presbyterian Hospital , New York , NY , USA.
[Ti] Título:Valbenazine as the first and only approved treatment for adults with tardive dyskinesia.
[So] Source:Expert Rev Clin Pharmacol;11(3):209-217, 2018 Mar.
[Is] ISSN:1751-2441
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Valbenazine is a selective VMAT2 inhibitor that the FDA approved in April 2017 for the specific treatment of tardive dyskinesia (TD), a movement disorder commonly caused by dopamine blocking agents. Valbenazine acts to decrease dopamine release, reducing excessive movement found in TD. Areas covered: This drug profile reviews the development of valbenazine and the clinical trials that led to its approval as the first treatment specific to TD. The literature search was performed with the PubMed online database. Expert commentary: Two clinical trials assessing the efficacy of valbenazine have shown the reduction of antipsychotic-induced involuntary movement. No life threatening adverse effects were found. Data from a 42-week extension study demonstrated sustained response.
[Mh] Termos MeSH primário: Dopamina/metabolismo
Discinesia Tardia/tratamento farmacológico
Tetrabenazina/análogos & derivados
Valina/análogos & derivados
[Mh] Termos MeSH secundário: Adulto
Animais
Antipsicóticos/administração & dosagem
Antipsicóticos/efeitos adversos
Antipsicóticos/farmacologia
Aprovação de Drogas
Seres Humanos
Discinesia Tardia/induzido quimicamente
Tetrabenazina/efeitos adversos
Tetrabenazina/farmacologia
Tetrabenazina/uso terapêutico
Valina/efeitos adversos
Valina/farmacologia
Valina/uso terapêutico
Proteínas Vesiculares de Transporte de Monoamina/antagonistas & inibidores
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antipsychotic Agents); 0 (SLC18A2 protein, human); 0 (Vesicular Monoamine Transport Proteins); 54K37P50KH (valbenazine); HG18B9YRS7 (Valine); VTD58H1Z2X (Dopamine); Z9O08YRN8O (Tetrabenazine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1080/17512433.2018.1429264


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[PMID]:27776953
[Au] Autor:Hui L; Han M; Yin GZ; Zhang Y; Huang XF; Qian ZK; Gu WG; Gu XC; Zhu XM; Soares JC; Ning Y; Zheng Y; Du XD; Zhang XY
[Ad] Endereço:Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, PR China.
[Ti] Título:Association between DBH 19bp insertion/deletion polymorphism and cognition in schizophrenia with and without tardive dyskinesia.
[So] Source:Schizophr Res;182:104-109, 2017 04.
[Is] ISSN:1573-2509
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Long-term antipsychotic treatment for schizophrenia is associated with the development of tardive dyskinesia (TD), which is involved in increased cognitive impairment. Dopamine beta-hydroxylase (DBH) gene associated with dopamine and norepinephrine systems influences cognition. Schizophrenia with TD have higher DBH activity than those without TD. This study examined whether DBH5'-insertion/deletion (-Ins/Del) polymorphism could influence cognitive function in schizophrenia with and without TD. The presence of DBH5'-Ins/Del polymorphism was determined in 345 schizophrenia with TD and 397 schizophrenia without TD. The Abnormal Involuntary Movement Scale and Repeatable Battery for Assessment of Neuropsychological Status (RBANS) were used to assess TD severity and cognition. The allele and genotype frequencies of DBH5'-Ins/Del polymorphism did not differ between patients with and without TD (both p>0.05). RBANS total score and subscales did not differ by DBH5'-Ins/Del genotype groups in patients with TD (all p>0.05). However, attention score significantly differed by DBH5'-Ins/Del genotype groups in those without TD (p<0.05). Patients without TD who were Del homozygous had significantly lower attention score than those without TD who were Ins alleles (p<0.05). Immediate memory and attention scores were lower in patients with TD than without TD (both p<0.05). This study indicated that DBH5'-Ins/Del polymorphism may not play a role in the susceptibility to TD and cognitive deficits in schizophrenia with TD, but it may influence cognitive function in schizophrenia with non-TD. Moreover, schizophrenia with TD experienced greater cognitive deficits than those with non-TD, especially in immediate memory and attention.
[Mh] Termos MeSH primário: Dopamina beta-Hidroxilase/genética
Polimorfismo de Nucleotídeo Único/genética
Esquizofrenia/complicações
Discinesia Tardia/etiologia
Discinesia Tardia/genética
[Mh] Termos MeSH secundário: Adulto
Transtornos Cognitivos/etiologia
Transtornos Cognitivos/genética
Feminino
Frequência do Gene
Estudos de Associação Genética
Genótipo
Seres Humanos
Mutação INDEL
Masculino
Meia-Idade
Testes Neuropsicológicos
Escalas de Graduação Psiquiátrica
Esquizofrenia/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
EC 1.14.17.1 (Dopamine beta-Hydroxylase)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180113
[Lr] Data última revisão:
180113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:28699794
[Au] Autor:Seeberger LC; Hauser RA
[Ad] Endereço:a Department of Neurology , University of Colorado , Denver , CO , USA.
[Ti] Título:Valbenazine for the treatment of tardive dyskinesia.
[So] Source:Expert Opin Pharmacother;18(12):1279-1287, 2017 Aug.
[Is] ISSN:1744-7666
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Tardive dyskinesia (TD) is a hyperkinetic movement disorder that may result from treatment with antipsychotics or other dopamine receptor blocking agents. Underlying pathophysiology is incompletely understood but since the 1970s dopamine depleting agents have been used to reduce involuntary movements. The search for safe, effective treatments for TD is ongoing. Valbenazine, a novel VMAT2 inhibitor, has recently been FDA approved for treatment of TD. Areas covered: An overview of TD, unmet medical needs and current treatment guidelines are presented. The background, chemistry and clinical development of valbenazine to treat TD is detailed. A competitive market is developing as the treatment gap is identified and potential therapies are discussed in context of a broader market overview. Expert opinion: Antipsychotic use is growing among adults and children in the U.S. Consequently, prevalence of TD is expected to rise. Cessation of antipsychotics is often not possible as the psychiatric condition may deteriorate. Increasing doses of an antipsychotic to suppress involuntary movements is not sustainable long term as underlying TD worsens and movements typically recur. There were no FDA approved treatments for TD. The approval of valbenazine to treat TD is a critical step in addressing this gap in neurologic care.
[Mh] Termos MeSH primário: Discinesia Tardia/tratamento farmacológico
Tetrabenazina/análogos & derivados
Valina/análogos & derivados
Proteínas Vesiculares de Transporte de Monoamina/antagonistas & inibidores
[Mh] Termos MeSH secundário: Antipsicóticos/efeitos adversos
Ensaios Clínicos como Assunto
Seres Humanos
Transtornos Mentais/tratamento farmacológico
Discinesia Tardia/induzido quimicamente
Discinesia Tardia/psicologia
Tetrabenazina/uso terapêutico
Resultado do Tratamento
Valina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antipsychotic Agents); 0 (SLC18A2 protein, human); 0 (Vesicular Monoamine Transport Proteins); 54K37P50KH (valbenazine); HG18B9YRS7 (Valine); Z9O08YRN8O (Tetrabenazine)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE
[do] DOI:10.1080/14656566.2017.1353078


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[PMID]:28682214
[Au] Autor:Pitzer M; Engelmann G; Stammschulte T
[Ad] Endereço:1 Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Städtisches Klinikum Karlsruhe.
[Ti] Título:[Tardive movement disorders with antipsychotics ­ a case of aripirazole-induced tardive dystonia and review of the literature].
[Ti] Título:Antipsychotika-induzierte tardive Bewegungsstörungen ­ Fallbeispiel einer tardiven Dystonie unter Aripiprazol und Literaturübersicht..
[So] Source:Z Kinder Jugendpsychiatr Psychother;45(4):325-334, 2017 07.
[Is] ISSN:1422-4917
[Cp] País de publicação:Switzerland
[La] Idioma:ger
[Ab] Resumo:Extrapyramidal adverse events (EPS) occur less frequently with second-generation antipsychotics (SGAs) than with first-generation antipsychotics (FGAs). Tardive dyskinesia (TD), but not tardive dystonia (TDt), also seems to occur less often in adults. TD was found to occur less frequently in children and adolescents treated with FGAs than in adults. No data are available on TDt, and the data pertaining to SGAs are limited and conflicting. SGAs differ in their profile of adverse events. Aripiprazole is less frequently associated with adverse metabolic or cardiac events, but more often with EPS, at least in children and adolescents. To date, there are several case reports of TD or TDt with aripiprazole in adults. Symptomatology, differential diagnosis, pathophysiology, prevalence, and therapy of TDt are presented here based on a case report of TDt during aripiprazole therapy in a 13-year-old girl. During medication with SGAs, the occurrence of EPS, including tardive movement disorders, should be considered and regularly monitored.
[Mh] Termos MeSH primário: Aripiprazol/efeitos adversos
Aripiprazol/uso terapêutico
Discinesia Tardia/diagnóstico
Síndrome de Tourette/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Criança
Diagnóstico Diferencial
Substituição de Medicamentos
Feminino
Seres Humanos
Masculino
Síndrome de Tourette/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; SCIENTIFIC INTEGRITY REVIEW
[Nm] Nome de substância:
82VFR53I78 (Aripiprazole)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1024/1422-4917/a000460


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[PMID]:28578484
[Au] Autor:Kim ES
[Ad] Endereço:Springer, Private Bag 65901, Mairangi Bay 0754, Auckland, New Zealand. dru@adis.com.
[Ti] Título:Valbenazine: First Global Approval.
[So] Source:Drugs;77(10):1123-1129, 2017 Jul.
[Is] ISSN:1179-1950
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:Valbenazine (Ingrezza™) is an orally bioavailable, selective, vesicular monoamine transporter 2 (VMAT2) inhibitor being developed by Neurocrine Biosciences for the treatment of various central nervous system disorders. Valbenazine has been approved in the USA for the treatment of adults with tardive dyskinesia (TD), is at various stages of development in other countries for TD and is in phase 2 development in the USA for Tourette syndrome. This article summarizes the milestones in the development of valbenazine leading to its first global approval in the USA for the treatment of adults with TD.
[Mh] Termos MeSH primário: Aprovação de Drogas
Discinesia Tardia/tratamento farmacológico
Tetrabenazina/análogos & derivados
Valina/análogos & derivados
[Mh] Termos MeSH secundário: Adulto
Ensaios Clínicos como Assunto
Seres Humanos
Tetrabenazina/efeitos adversos
Tetrabenazina/química
Tetrabenazina/farmacocinética
Tetrabenazina/uso terapêutico
Síndrome de Tourette/tratamento farmacológico
Estados Unidos
United States Food and Drug Administration
Valina/efeitos adversos
Valina/química
Valina/farmacocinética
Valina/uso terapêutico
Proteínas Vesiculares de Transporte de Monoamina/antagonistas & inibidores
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Vesicular Monoamine Transport Proteins); 54K37P50KH (valbenazine); HG18B9YRS7 (Valine); Z9O08YRN8O (Tetrabenazine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170605
[St] Status:MEDLINE
[do] DOI:10.1007/s40265-017-0770-9


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[PMID]:28577245
[Au] Autor:Bielefeldt K
[Ad] Endereço:George E. Wahlen VA Medical Center, Salt Lake City Specialty Care Center of Innovation and University of Utah, 500 Foothill Dr., Salt Lake City, UT, 84148, USA. Klaus.Bielefeldt@va.gov.
[Ti] Título:From Harmful Treatment to Secondary Gain: Adverse Event Reporting in Dyspepsia and Gastroparesis.
[So] Source:Dig Dis Sci;62(11):2999-3013, 2017 Nov.
[Is] ISSN:1573-2568
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Medical management of gastroparesis and functional dyspepsia remains difficult with several recent trials showing limited or no benefit. If treatment comes with only marginal improvements, concerns about adverse events become more relevant. We therefore examined the type and outcomes of side effects submitted to a public repository. METHODS: We searched the Federal Adverse Event Reporting System for reports associated with the treatment of dyspepsia or gastroparesis. Demographic data, medications used and implicated, side effects, and outcomes were abstracted for the years 2004-2015. RESULTS: Acid-suppressive agents and prokinetics were the most commonly listed medications with a stronger emphasis on prokinetics in gastroparesis. Submissions related to metoclopramide by far exceeded reports about other agents and mostly described tardive dyskinesia or other neurological concerns. They peaked around 2012, driven by submissions through legal workers. Most reports about metoclopramide described short-term use to prevent or treat nausea and vomiting. Concerns about acid-suppressive medications increased over time and spanned a wide spectrum of potential problems, including osteoporosis, worsening renal function, or cardiac events. CONCLUSION: Despite biasing factors, such as pending legal action, the voluntary repository of adverse events provides insight into current medical practice and its associated risk. Knowing about common and uncommon, but potentially serious risks may enable patients and providers to decide on effective and safe management strategies.
[Mh] Termos MeSH primário: Sistemas de Notificação de Reações Adversas a Medicamentos
Transtornos de Deglutição/tratamento farmacológico
Fármacos Gastrointestinais/efeitos adversos
Gastroparesia/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Idoso
Antieméticos/efeitos adversos
Bases de Dados Factuais
Transtornos de Deglutição/diagnóstico
Transtornos de Deglutição/fisiopatologia
Antagonistas dos Receptores de Dopamina D2/efeitos adversos
Feminino
Gastroparesia/diagnóstico
Gastroparesia/fisiopatologia
Seres Humanos
Masculino
Metoclopramida/efeitos adversos
Meia-Idade
Segurança do Paciente
Inibidores da Bomba de Prótons/efeitos adversos
Medição de Risco
Fatores de Risco
Discinesia Tardia/induzido quimicamente
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiemetics); 0 (Dopamine D2 Receptor Antagonists); 0 (Gastrointestinal Agents); 0 (Proton Pump Inhibitors); L4YEB44I46 (Metoclopramide)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170604
[St] Status:MEDLINE
[do] DOI:10.1007/s10620-017-4633-8


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[PMID]:28489481
[Au] Autor:Davis MC; Miller BJ; Kalsi JK; Birkner T; Mathis MV
[Ad] Endereço:From the Division of Psychiatry Products (M.C.D., B.J.M., J.K.K., M.V.M.) and the Division of Biometrics I (T.B.), Center for Drug Evaluation and Research, Silver Spring, MD; and the University of North Carolina Kenan-Flagler School of Business, Chapel Hill (B.J.M.).
[Ti] Título:Efficient Trial Design - FDA Approval of Valbenazine for Tardive Dyskinesia.
[So] Source:N Engl J Med;376(26):2503-2506, 2017 Jun 29.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aprovação de Drogas/métodos
Discinesia Tardia/tratamento farmacológico
Tetrabenazina/análogos & derivados
Valina/análogos & derivados
Proteínas Vesiculares de Transporte de Monoamina/antagonistas & inibidores
[Mh] Termos MeSH secundário: Antipsicóticos/efeitos adversos
Antipsicóticos/uso terapêutico
Ensaios Clínicos Fase III como Assunto
Dopamina/secreção
Seres Humanos
Transmissão Sináptica/efeitos dos fármacos
Transmissão Sináptica/fisiologia
Discinesia Tardia/induzido quimicamente
Tetrabenazina/uso terapêutico
Estados Unidos
United States Food and Drug Administration
Valina/uso terapêutico
Proteínas Vesiculares de Transporte de Monoamina/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antipsychotic Agents); 0 (SLC18A2 protein, human); 0 (Vesicular Monoamine Transport Proteins); 54K37P50KH (valbenazine); HG18B9YRS7 (Valine); VTD58H1Z2X (Dopamine); Z9O08YRN8O (Tetrabenazine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170511
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1704898


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[PMID]:28446646
[Au] Autor:Fernandez HH; Factor SA; Hauser RA; Jimenez-Shahed J; Ondo WG; Jarskog LF; Meltzer HY; Woods SW; Bega D; LeDoux MS; Shprecher DR; Davis C; Davis MD; Stamler D; Anderson KE
[Ad] Endereço:From the Cleveland Clinic (H.H.F.), Center for Neurological Restoration, Cleveland, OH; Emory University (S.A.F.), Atlanta, GA; University of South Florida Parkinson's Disease and Movement Disorders Center (R.A.H.), Tampa, FL; Baylor College of Medicine (J.J.-S.), Houston, TX; Methodist Neurological
[Ti] Título:Randomized controlled trial of deutetrabenazine for tardive dyskinesia: The ARM-TD study.
[So] Source:Neurology;88(21):2003-2010, 2017 May 23.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the efficacy and safety of deutetrabenazine as a treatment for tardive dyskinesia (TD). METHODS: One hundred seventeen patients with moderate to severe TD received deutetrabenazine or placebo in this randomized, double-blind, multicenter trial. Eligibility criteria included an Abnormal Involuntary Movement Scale (AIMS) score of ≥6 assessed by blinded central video rating, stable psychiatric illness, and stable psychoactive medication treatment. Primary endpoint was the change in AIMS score from baseline to week 12. Secondary endpoints included treatment success at week 12 on the Clinical Global Impression of Change (CGIC) and Patient Global Impression of Change. RESULTS: For the primary endpoint, deutetrabenazine significantly reduced AIMS scores from baseline to week 12 vs placebo (least-squares mean [standard error] -3.0 [0.45] vs -1.6 [0.46], = 0.019). Treatment success on CGIC (48.2% vs 40.4%) favored deutetrabenazine but was not significant. Deutetrabenazine and placebo groups showed low rates of psychiatric adverse events: anxiety (3.4% vs 6.8%), depressed mood/depression (1.7% vs 1.7%), and suicidal ideation (0% vs 1.7%, respectively). In addition, no worsening in parkinsonism, as measured by the Unified Parkinson's Disease Rating Scale motor subscale, was noted from baseline to week 12 in either group. CONCLUSIONS: In patients with TD, deutetrabenazine was well tolerated and significantly reduced abnormal movements. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that in patients with TD, deutetrabenazine reduces AIMS scores.
[Mh] Termos MeSH primário: Fármacos Neuromusculares/uso terapêutico
Discinesia Tardia/tratamento farmacológico
Tetrabenazina/análogos & derivados
[Mh] Termos MeSH secundário: Comorbidade
Método Duplo-Cego
Europa (Continente)
Feminino
Seres Humanos
Análise dos Mínimos Quadrados
Masculino
Transtornos Mentais/complicações
Transtornos Mentais/tratamento farmacológico
Meia-Idade
Fármacos Neuromusculares/efeitos adversos
Índice de Gravidade de Doença
Discinesia Tardia/complicações
Discinesia Tardia/psicologia
Tetrabenazina/efeitos adversos
Tetrabenazina/uso terapêutico
Resultado do Tratamento
Estados Unidos
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Neuromuscular Agents); 0 (deutetrabenazine); Z9O08YRN8O (Tetrabenazine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000003960


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[PMID]:28443349
[Au] Autor:Witter DP; Holbert RC; Suryadevara U
[Ad] Endereço:a Department of Psychiatry , University of Florida College of Medicine , Gainesville , FL , USA.
[Ti] Título:Pharmacotherapy for the treatment of tardive dyskinesia in schizophrenia patients.
[So] Source:Expert Opin Pharmacother;18(10):965-972, 2017 Jul.
[Is] ISSN:1744-7666
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Tardive dyskinesia (TD) is an iatrogenic movement disorder most commonly observed in patients with psychotic disorders who are treated with dopamine blocking antipsychotic medications. Treatment options are limited, and recommendations for treatment are based on a relative scarcity of evidence. Areas covered: After briefly highlighting current mechanistic theories of TD, this review will discuss the evidence for a number of medications of several different classes that have been studied for the treatment of TD since the 1970s with an emphasis on placebo controlled trials when possible. We used a Pubmed search of primary studies, reviews, and metaanalyses on the topic of TD treatment in order to cover this topic. Expert opinion: Treatment of TD is difficult given limited data and incomplete understanding of the mechanism. Treatment of TD must be evaluated on an individual basis with careful weight given to severity of symptoms. We suggest the use of atypical versus conventional antipsychotics whenever possible and would recommend trials with one or more of a number of additional agents starting with valbenazine.
[Mh] Termos MeSH primário: Antipsicóticos/efeitos adversos
Antagonistas de Dopamina/efeitos adversos
Esquizofrenia/tratamento farmacológico
Discinesia Tardia/tratamento farmacológico
[Mh] Termos MeSH secundário: Antipsicóticos/administração & dosagem
Antipsicóticos/uso terapêutico
Antagonistas de Dopamina/administração & dosagem
Antagonistas de Dopamina/uso terapêutico
Seres Humanos
Discinesia Tardia/induzido quimicamente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antipsychotic Agents); 0 (Dopamine Antagonists)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171118
[Lr] Data última revisão:
171118
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1080/14656566.2017.1323874



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