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Moving Ahead, Another Movement Disorder

Jessica Goldenberg

For many years schizophrenia was thought to be caused by bad parenting, the so-called "refrigerator mother" was to blame. Today there exists much more information on the disorder and the evidence points to the commonly accepted notion of a chemical imbalance in the brain. Unfortunately, many people still confuse schizophrenia with multiple personality disorder when, in fact, the two are separate. Schizophrenia however, deals more with people who simply don't have a firm grip on reality.

In recent years researchers have made significant advances in the field and have come up with many neuroleptic (antipsychotic) medications to treat the disorder. However along with these medical breakthroughs problems have occurred. The most severe side effect is called Tardive Dyskinesia, literally meaning "late movement disorder." (1) Coined in 1964, it is identified by the involvement of numerous "abnormal, involuntary movements of the orofacial area or extremities." . (2) More specifically, it is characterized by rocking, twisting, jerking, toe tapping, lip smacking, blinking, and most commonly an unusual movement of the tongue. . (1) (2)(3). Interestingly enough, these side effects disappear during sleep. (3)

Neuroleptic-induced Tardive Dyskinesia occurs in roughly fifteen to twenty percent of people taking neuroleptic drugs for several years, and often exceeds fifty percent when all patients treated with neuroleptic are considered. (1)(4) Tardive Dyskinesia develops in people of all ages and walks of life, but the elderly, especially men, and those who are mute, unable to reason and understand competently, and those who have lost their teeth are more likely to develop the disorder. (5)

The cause of Tardive Dyskinesia has not been positively identified, but researchers do know that neuroleptic drugs change the way nerve impulses jump from the pre-synaptic neurons across a synapse to the post-synaptic neurons. (2). Such drugs prevent the neurotransmitter dopamine from reaching the brain, "directly impairing the function of the basal ganglia and the emotion-regulating limbic system and frontal lobes." (6)

Drugs such as Haldol, Navane, Thorazine, Mellaril, Stelazine, Clozaril, and Resperisal are believed to cause Tardive Dyskinesia. (6) Resperidal however, seems to cause a less severe from of Tardive Dyskinesia. (6) Currently researchers are exploring the idea that calcium-channel blockers can treat those with neuroleptic-induced Tardive Dyskinesia. Unfortunately, not enough research has been carried out to date. (7).

Recent studies have shown, though somewhat ambiguously, that GABA (gamma amino butyric acid, a usually inhibitory neurotransmitter) gives some improvement over the symptoms of Tardive Dyskinesia. (7) It has also been found that buspirone has a possibility of improving the symptoms of neuroleptic-induced Tardive Dyskinesia. (3)

Tardive Dyskinesia is an unfortunate side effect of the treatment for schizophrenia but one may ask "which debilitating act a patient is willing to live with?" The aforementioned question is one that should never be asked. For if "neuroleptics were used to treat anyone other than mental patients, they would have been banned a long time ago. (4). In addition more research would be being conducted at present time.

The only way to improve the situation with Tardive Dyskinesia and schizophrenia is to educate others about them, and more generally about mental illness. When people start thinking of and accepting mental illness, like they do of other sicknesses, breakthroughs in the field will emerge, and patients will finally receive the treatment they rightly deserve.

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