{"id":4044,"date":"2021-07-19T23:23:26","date_gmt":"2021-07-19T23:23:26","guid":{"rendered":"https:\/\/curesz.org\/?page_id=4044"},"modified":"2023-08-14T11:39:55","modified_gmt":"2023-08-14T15:39:55","slug":"tardive-dyskinesia-be-your-own-advocate","status":"publish","type":"page","link":"https:\/\/curesz.org\/pt_pt\/tardive-dyskinesia-be-your-own-advocate\/","title":{"rendered":"Discinesia tardia: seja seu pr\u00f3prio advogado"},"content":{"rendered":"

<\/span><\/div>

Dr. Craig Chepke<\/a>, Psiquiatra de consult\u00f3rio particular e Professor assistente adjunto de Psiquiatria, Escola de Medicina da Universidade da Carolina do Norte, Membro do Conselho da CURESZ<\/p>\n<\/div><\/div><\/div>

A discinesia tardia (DT) \u00e9 uma s\u00edndrome neurol\u00f3gica de in\u00edcio tardio que pode ocorrer como efeito colateral do uso prolongado de medicamentos antipsic\u00f3ticos. As pessoas que desenvolvem DT podem ter movimentos involunt\u00e1rios repetitivos que geralmente s\u00e3o lentos e contorcidos, ou de natureza dan\u00e7ante. Os movimentos ocorrem mais comumente nos m\u00fasculos da face, boca e l\u00edngua, mas tamb\u00e9m podem aparecer nos bra\u00e7os, pernas ou tronco. As estimativas da frequ\u00eancia de DT diferem, mas variam de 7%-30% de pessoas que tomam antipsic\u00f3ticos por um per\u00edodo prolongado.1<\/sup>\u00a0O tempo de exposi\u00e7\u00e3o necess\u00e1rio para desenvolver DT \u00e9 vari\u00e1vel, mas pode ocorrer meses ou mesmo anos ap\u00f3s o in\u00edcio do tratamento com um antipsic\u00f3tico. Uma vez que a TD se manifesta, ela pode se tornar irrevers\u00edvel. Portanto, a detec\u00e7\u00e3o precoce e o tratamento da discinesia tardia s\u00e3o cr\u00edticos.<\/em><\/p>\n

Sinto-me honrado em fazer parte do CURESZ\u00a0Painel de especialistas em discinesia tardia<\/a>, but I haven\u2019t always been adept at diagnosing TD. For years, no one in my current practice seemed to have \u201cobvious\u201d symptoms of TD, so I came to assume that it was more of a historical problem associated with the older first-generation antipsychotics that I rarely prescribe. In 2016, however, I began working with a young man with schizophrenia whose TD was unmistakable. With no FDA-approved medications at the time, the best I could offer was to remove or reduce one of the two antipsychotics he was taking. He and his father wouldn\u2019t consider any change, because that combination was the only thing that had ever worked for him. When his father suddenly passed away months later, his grief inspired me to learn as much as I could about treating TD. I couldn\u2019t give him his father back, but I could at least try to give him the dignity of control over his body.<\/p>\n

I studied neurology journals and textbooks for months and realized that I had unconsciously set my bar for diagnosing TD at only the highest severity level. I had inadvertently become blind to detecting mild to moderate TD. Reading the numerous failed clinical trials of medications and supplements for treating TD, I gained an appreciation of the decades of powerlessness clinicians had felt in trying to treat it. It seemed that recognition of TD was gradually overshadowed by increased screening for other potential side effects of antipsychotics, such as blood sugar and cholesterol elevations– perhaps because the latter are problems for which we have long had good treatment options. In 2017, the FDA approved the first two medications for TD, and treating my patient with one of them benefitted him in profound ways I didn\u2019t expect.<\/p>\n

Every psychiatric provider trained in an era in which there was little or nothing we could do to address TD, so many didn\u2019t have enough urgency looking for it. Our diagnostic skills withered, and many newer clinicians never established proficiency in the first place. Now that approved treatments exist, the mental health field will eventually enhance its recognition of TD, but if I didn\u2019t have this unique experience when I did, it might have been years before I stepped up my screening. Until every provider makes a thorough examination for TD a standard part of their appointments, I urge everyone taking an antipsychotic, especially anyone experiencing unusual or unexpected movement problems, to be your own advocate and take the lead in discussing tardive dyskinesia treatment with your provider.<\/p>\n

Refer\u00eancia: 1. Carbon et al. J Clin Psychiatry 2017;78(3):e264\u2013e278.<\/p>\n

<\/h2>\n<\/div><\/div><\/div><\/div><\/div>
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