Movement Disorder Side Effects Related to Adjunctive Use of an Atypical Antipsychotic in Patients With Major Depressive Disorder

Overview: 

Through this short video, you’ll learn more about akathisia and tardive dyskinesia as being possible movement disorder side effects related to the adjunctive use of atypical antipsychotics in adult patients with MDD. 
 

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Sponsored by: AbbVie Medical Affairs

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Roger McIntyre, MD, FRCPC

Dr Roger S McIntyre is a professor of Psychiatry and Pharmacology at the University of Toronto. He is the chair and executive director of the Brain and Cognition Discovery Foundation in Toronto, Ontario, Canada, and the board chair of the Board of Directors of the Depression and Bipolar Support Alliance in Chicago, Illinois, USA. Additionally, he is a fellow of the American Psychiatric Association. Professor McIntyre is involved in multiple research endeavors that primarily aim to characterize the phenomenology, neurobiology, and novel therapeutics of mood disorders. Professor McIntyre is the lead author of the Florida Best Practice Psychotherapeutic Medication Guidelines for Adults with Major Depressive Disorder and Bipolar Disorder, and he is a contributor to the Canadian Network for Mood and Anxiety Treatments guidelines for the treatment of depressive and bipolar disorders. He has published more than 900 articles and edited several textbooks on mood disorders. 

References​:

1. American Psychiatric Association. Practice Guideline for the Treatment of Patients With Major Depressive Disorder. 3rd ed. American Psychiatric Association; 2010. ​

2. Divac N, Prostran M, Jakovcevski I, Cerovac N. Second-generation antipsychotics and extrapyramidal adverse effects. Biomed Res Int. 2014:2014:656370. doi:10.1155/2014/656370

3. Martino D, Karnik V, Osland S, Barnes TRE, Pringsheim TM. Movement disorders associated with antipsychotic medication in people with schizophrenia: an overview of Cochrane reviews and meta-analysis. Can J Psychiatry. 2018;63(11):730–739.

4. Loughlin AM, Lin N, Abler V, Carroll B. Tardive dyskinesia among patients using antipsychotic medications in customary clinical care in the United States. PLoS One. 2019;14(6):e0216044. doi:10.1371/journal.pone.0216044 

5. Citrome L, Yatham LN, Patel MD, Barabássy Á, Hankinson A, Earley WR. Cariprazine and akathisia, restlessness, and extrapyramidal symptoms in patients with bipolar depression. J Affect Disord. 2021;288:191-198. doi:10.1016/j.jad.2021.03.076 

6. Barnes TR. A rating scale for drug-induced akathisia. Br J Psychiatry. 1989;154:672-6. doi:10.1192/bjp.154.5.672

7. Chow CL, Kadouh NK, Bostwick JR, VandenBerg AM. Akathisia and newer second-generation antipsychotic drugs: a review of current evidence. Pharmacotherapy. 2020;40(6):565-574. doi:10.1002/phar.2404 

8. Patel J, Marwaha R. Akathisia. StatPearls [Internet]. January 2023. Updated July 24, 2023. https://www.ncbi.nlm.nih.gov/books/NBK519543/ 

9. Takeuchi H, Mori Y, Tsutsumi Y. Pathophysiology, prognosis and treatment of tardive dyskinesia. Ther Adv Psychopharmacol. 2022;12:20451253221117313. doi:10.1177/20451253221117313 

10. McEvoy JP. Psychosocial implications of tardive dyskinesia in patients with mood disorders versus schizophrenia. J Cin Psychiatry. 2019;80(6):NU18041BR2C. doi:10.4088/JCP.NU18041BR2C ​

11. Abnormal Involuntary Movement Scale (117-AIMS). In: Guy W, ed. ECDEU Assessment Manual for Psychopharmacology. National Institute of Mental Health; 1976:534-537.

12. Kane JM, Correll CU, Nierenberg AA, Caroff SN, Sajatovic M; Tardive Dyskinesia Assessment Working Group. Revisiting the Abnormal Involuntary Movement Scale: proceedings from the tardive dyskinesia assessment workshop. J Clin Psychiatry. 2018;79(3):17cs11959. doi:10.4088/JCP.17cs11959 ​

13. Cariprazine. Prescribing information. Allergan USA, Inc.; December 2022. ​

14. Sachs G, Yeung P, Rekeda L, et al. Adjunctive cariprazine for the treatment of patients with major depressive disorder: a randomized, double-blind, placebo-controlled phase 3 study. Am J Psychiatry. 2023;180(3):241-251. doi:10.1176/appi.ajp.20220504​

15. Durgam S, Earley W, Guo H, et al. Efficacy and safety of adjunctive cariprazine in inadequate responders to antidepressants: a randomized, double-blind, placebo-controlled study in adult patients with major depressive disorder. J Clin Psychiatry. 2016;77(3):371-378. doi:10.4088/JCP.15m10070​

16. Matthews-Hayes T, Cerulli T, Wilson AC, et al. Incidence and characteristics of akathisia with adjunctive cariprazine treatment in patients with major depressive disorder. Poster presented at: International College of Neuropsychopharmacology (CINP) World Congress; May 7 - 10, 2023; Montreal, Canada.​

17. AbbVie Inc. Data on file. ​