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TD hazards among the retarded.

TD hazards among the retarded

It is estimated that somewhere between 15 percent and 25 percent of psychiatric patients treated with neuroleptic drugs develop tardive dyskinesia (TD), a movement disorder marked by involuntary twitching of the mouth, lips,tongue, arms, legs or trunk (SN: 7/20/85, p. 45). That proportion may climb to as high as 34 percent among mentally retarded patients treated with the same drugs, according to a report in the April ARCHIVES OF GENERAL PSYCHIATRY.

In a survey of 38 mentally retarded children, adolescents and young adults withdrawn from neuroleptics after an average of eight years of institutional or outpatient treatment, C. Thomas Gualtieri of the University of North Carolina at Chapel Hill and his colleagues observed 13 cases of TD. The diagnosis was made only if abnormal movements persisted for at least four months after drug withdrawal. Five of the TD patients still have symptoms three years after withdrawal. Eight individuals had moderate to severe symptoms.

Ironically, movement disorders are often masked during drug treatment, appearing after neuroleptics are discontinued. The medication is commonly used to ease psychotic symptoms in schizophrenia and other mental disorders.

It is also widely used with the retarded to control behavior problems, says Gualtieri, although there is little research on its effectiveness in such cases. Videotapes of subjects were carefully assessed and checked by four independent physicians, he notes, in order to distinguish between the often peculiar movements of retarded individuals and instances of TD.

The sample is small and may not represent all mentally retarded patients, says Gualtieri, but "TD, including severe and persistent TD, represents a substantial harzard to young retarded people treated with neuroleptic drugs."
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Title Annotation:tardive dyskinesia
Publication:Science News
Date:Apr 19, 1986
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