Posted: March 12th, 2023

Replies for peers. Need ONE Response Per Each Discussion Total 8 Responses. Attached Are The Discussions And Rubric Please Follow Them. Posts Will Be A Minimum Of 100 Words, APA Format.One Reference Per Each Discussion

Robert Alonso

21 minutes ago, at 5:21 PM

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The symptoms of psychotic diseases include delusions, hallucinations, abnormal thinking, and behavior. Psychotic disorders are mental conditions that make a person lose touch with reality. The most effective course of treatment for these disorders is an antipsychotic medication. The effective antipsychotic drug risperidone targets particular brain receptors, but it also has a number of potential negative side effects. This essay examines the use of risperidone as well as the distinctions between tics, athetosis, acute dystonia, and tardive dyskinesia.

Risperidone is a second-generation or atypical antipsychotic medication primarily used to treat schizophrenia, bipolar disorder, and other psychotic disorders. Risperidone works by blocking the dopamine D2 receptor and the serotonin 5-HT2A receptor in the brain, decreasing the positive symptoms of psychosis (Mao et al., 2021). It is available in different dosage forms, including oral, dissolving, and injections. Its most common side effects are weight gain, sedation, and akathisia, a feeling of restlessness or agitation. According to Mayo Clinic (2023), its recommended adult dose is 2-3mg daily.

 

It is important to know the differences between the various movement disorders associated with antipsychotic medications. Tardive dyskinesia, athetosis, acute dystonia, and tics are all movement disorders that can occur as rare side effects of antipsychotic medication use. Tardive dyskinesia and athetosis are long-term side effects that can develop after months or years of medication use. Acute dystonia and tics, on the other hand, are acute side effects that can occur shortly after starting the medication (Jain, 2021). The causes of these movement disorders are related to the blockade of dopamine receptors in the brain. Treatment options for these side effects include stopping or reducing the medication or switching to a different medication. It is important for healthcare professionals to monitor patients on antipsychotic medications for any signs of movement disorders and adjust treatment as necessary.

In conclusion, Risperidone is an effective antipsychotic medication that targets specific brain receptors but may also produce several side effects. Tardive dyskinesia, acute dystonia, athetosis, and tics, have unique features and require different treatments. Healthcare professionals should monitor patients for these side effects and adjust treatment accordingly. Patients should also be informed of the potential risks and benefits of antipsychotics. 

  

Yordanis Santana Soayero

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Chlorpromazine

Chlorpromazine is an antipsychotic medication that treats several psychotic disorders like schizophrenia, severe anxiety, and bipolar disorder.

Working Mechanism

Chlorpromazine blocks the dopamine, histamine receptors, serotonin, and acetylcholine activities in the brain. Chlorpromazine is a dopamine D2 receptor antagonist, which means that it minimizes the actions of dopamine in the brain (Ozawa, 2021). This helps to reduce symptoms of psychosis, which are thought to be related to overactivity of the dopamine system.

Dosage

Chlorpromazine is available in liquid forms, oral tablets, and capsules. Dosage varies depending on the patient’s condition but ranges from 25 to 200 mg daily, taken in divided doses. However, higher doses may be necessary in some cases.

Potential Side Effects

Some common side effects of Chlorpromazine are dizziness, drowsiness, weight gain, poor vision, dry mouth, and constipation. Chlorpromazine also causes other side effects, like neuroleptic malignant symptoms, Receptors affected in the brain and tardive dyskinesia. Chlorpromazine blocks dopamine receptors in the brain, specifically the dopamine D2 receptor. It also affects other receptors, including serotonin5-HT3 receptors and 5-HT2A, 5-HT2C, alpha-adrenergic receptors, and histamine H1 receptors.

 

Patients should work with their healthcare providers to detect possible side effects and adjust the dosage on time. Chlorpromazine should not be used without medical supervision, and patients should never stop taking the medication abruptly without consulting their healthcare provider, as this can lead to withdrawal symptoms.

 Tics, tardive dyskinesia, athetosis, and acute dystonia are movement disorders caused by the use of antipsychotic medications, but they have different characteristics and presentations. Tardive dyskinesia is a neurological condition identified by repetitive, involuntary face movements, tongue, lips, and extremities after using antipsychotics for a long time. Acute dystonia is a sudden, painful muscle spasm in the tongue, face, and neck (Lang, 2021). Athetosis is characterized by slow, writhing movements of the body and limbs caused by brain disease or injury. Tics are sudden, involuntary, and repetitive sounds or movements such as eye blinking, facial grimacing, or throat clearing and can be symptoms of Tourette syndrome. Generally, these movement disorders have distinct clinical characteristics, underlying causes, and treatments and can impact life quality in several ways.

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Yolanda Morgado

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Antipsychotic Medication: Phenothiazines

           Phenothiazines is an antipsychotic medication often used to treat severe emotional and mental disorders. The medication also controls agitation, severe hiccups, severe vomiting and nausea, and severe pain in hospitalized patients. However, the medication may have several side effects, such as constipation, memory-related issues, trouble urinating, confusion, and dry mouth, among other related effects(Edinoff et al., 2022). Also, it may cause uncontrolled and unattractive body and face movements even after one stops taking the medication. The recommended dosage for this antipsychotic medication is between 0.25 and 0.75 mg one to four times a day in children, and the approximate dosage is between 1 and 2.5 mg once a day for adults. However, the healthcare provider may increase the dosage based on the patient’s condition. Addition by, Phenothiazine’s being an antipsychotic medication, its mechanism of action emphasizes central and peripheral dopaminergic blockade. Most Phenothiazine medications comprise anticholinergic, sodium and potassium channel-blocking, and α receptor-blocking aspects(Edinoff et al., 2022). Lastly, phenothiazines tend to impact the brain by blocking the postsynaptic neurotransmission by combining the histamine H1, dopamine, serotonergic 5-hydroxytryptamine (HT) 2, and muscarinic receptors.

Compare and Contrast

           Tardive dyskinesia may be described as a drug-induced movement disorder mainly caused by the consumption of particular medication for mental health disorders (“Tardive dyskinesia and other late-onset movement disorders,” 2010). This condition causes uncontrollable facial tic and lip-smacking, among others. 

On the other hand, acute dystonia may be described as an uncontrollable contraction of the face, abdomen, extremities, pelvis, neck, and larynx muscles within a sustained or intermittent pattern, often leading to abnormal posture or movement (“Tardive dyskinesia and other late-onset movement disorders,” 2010).

Athetosis may be described as a writhing, slow, and continuous worm-like movement of the trunk or the limbs(“Tardive dyskinesia and other late-onset movement disorders,” 2010). This condition may affect the lounge, neck, and face. Furthermore, the condition often occurs as an injury to the basal ganglia.

On the other hand, tics may be described as sudden movements, twitches, or sounds conducted repeatedly by individuals. Tics tend to be uncontrollable movements of the face or the body(“Tardive dyskinesia and other late-onset movement disorders,” 2010).

  

Anisley Longa

Olanzapine is a second-generation (atypical) antipsychotic medication. The FDA has approved this medication for schizophrenia if the patient is over the age of 13 and bipolar disorder, including mixed or manic episodes. Olanzapine is also approved for use with fluoxetine, a selective serotonin reuptake inhibitor (SSRI), in patients with episodes of depression associated with bipolar disorder type 1 and treatment-resistant depression. It is important to note that olanzapine is not FDA-approved for patients under the age of 13. In addition, the combination of olanzapine with fluoxetine is not approved for patients under the age of 10. This activity covers olanzapine, including mechanism of action, pharmacology, adverse event profiles, eligible patient populations, contraindications, and monitoring, and highlights the role of the interprofessional team in the management of olanzapine therapy. Olanzapine is a second-generation (atypical) antipsychotic medication. FDA has recently approved olanzapine in combination with samidorphan to attenuate olanzapine-induced weight gain. 

Indications

·       Schizophrenia if the patient is over the age of 13 years

·       Bipolar I disorder, for acute treatment of manic or mixed episodes.

·       Olanzapine also has approval for use with fluoxetine, a selective serotonin reuptake inhibitor (SSRI), in patients with episodes of depression associated with bipolar disorder type 1 and treatment-resistant depression. It is essential to recognize that olanzapine is not FDA-approved for patients under the age of thirteen years. The combination of olanzapine with fluoxetine does not have approval for patients under the age of 10 years.

·       The FDA has recently approved olanzapine in combination with samidorphan to attenuate olanzapine-induced weight gain for schizophrenia and bipolar I disorder. 

Olanzapine is an atypical (second-generation) antipsychotic that exerts its action primarily on dopamine and serotonin receptors. It works on dopamine D2 receptors in the mesolimbic pathway as an antagonist, blocking dopamine from potential action at the post-synaptic receptor. Olanzapine binds loosely to the receptor and dissociates easily, allowing for normal dopamine neurotransmission.

The effect on the D2 receptors leads to a decrease in positive symptoms in patients, including hallucinations, delusions, and disorganized speech, thought, and behavior. Olanzapine works similarly on serotonin 5HT2A receptors in the frontal cortex as an antagonist.

The effect of olanzapine on serotonin decreases negative symptoms, including anhedonia, flat affect, alogia, avolition, and poor attention. 

Adverse effect.

One of the most common adverse effects of olanzapine is the potential for weight gain. Olanzapine causes an increase in appetite leading to hyperphagia with a consequence of weight gain. Therefore, it should be used cautiously in patients who are obese, have little control over their food intake, and do not exercise regularly to combat weight gain. 

Another adverse effect of olanzapine is the increased risk of metabolic effects. Olanzapine has a high potential to cause reduced insulin sensitivity, leading to impaired glucose tolerance, especially in a younger population. While an exact mechanism for these adverse effects is still under debate, evidence suggests that the WNT signaling pathway effector TCF7L2 plays a vital role in glucose homeostasis. Olanzapine-induced weight gain and decreased insulin sensitivity lead to increased expression of TCF7L2 in the liver and skeletal muscle. Elevated insulin levels lead to increased expression of TCF7L2 in adipose tissue. This increased expression of TCF7L2 in multiple body tissues, which all play a role in glucose metabolism, suggests the mechanism for metabolic dysfunction caused by olanzapine. This finding also contributes to a possible therapeutic target to prevent or treat the adverse metabolic effects of olanzapine. 

Olanzapine’s mechanism of action also lends itself to directly causing adverse reactions associated with the dopaminergic blockade. Patients have an increased risk of developing akathisia, extrapyramidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome. However, the risk of developing these side effects is lesser than first-generation antipsychotics due to the lower affinity and rapid dissociation of olanzapine with the D2 receptors. 

Hematological abnormalities such as neutropenia and thrombocytopenia are reported. Post-marketing surveillance has also reported cases of hypothermia and edema due to olanzapine. 

Olanzapine is contraindicated in patients with a known hypersensitivity to this medication or medications in its class. There is a boxed warning for olanzapine regarding dementia-related psychosis. Elderly patients with dementia who present with symptoms of psychosis should not be prescribed olanzapine due to an increased mortality risk due to increased risk of heart failure, sudden death due to cardiac causes, and pneumonia. Concomitant use of parenteral olanzapine (high dose) with benzodiazepines is not advised due to sedation and the risk of severe cardiorespiratory depression. 

Additionally, due to the adverse effects of weight gain and metabolic dysfunction, clinicians should use this medication with caution in patients who are obese or have diabetes mellitus. However, using olanzapine is not an absolute contraindication in these patients. 

Obdelis Dominguez

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Antipsychotic Medication: Aripiprazole

Aripiprazole is an antipsychotic medication used in the treatment of psychotic disorders, including schizophrenia and bipolar disorder. Aripiprazole works by binding to several different receptors in the brain, including dopamine D2, serotonin 5-HT1A, and serotonin 5-HT2A receptors. It is a partial agonist at D2 and 5-HT1A receptors and an antagonist at 5-HT2A receptors (Gettu et al., 2020). This unique mechanism of action is thought to contribute to its efficacy in reducing symptoms of psychosis while minimizing side effects.

The recommended starting dose of aripiprazole for schizophrenia is 10-15 mg per day, while the recommended starting dose for bipolar disorder is 15 mg per day. For schizophrenia, the dosage may be progressively raised to a maximum of 30 mg per day, and for bipolar disorder, the quantity can be gradually increased to 30-45 mg per day. It is available in several different formulations, including oral tablets, orally disintegrating tablets, and injectable formulations.

Like all antipsychotics, aripiprazole has potential side effects. Some of the common side effects include weight gain, sleepiness, and akathisia, which is a feeling of restlessness or inability to sit still. Other potential adverse effects include extrapyramidal symptoms, such as acute dystonia, akathisia, and parkinsonism (Gettu et al., 2020). Aripiprazole is associated with a relatively low risk of causing extrapyramidal symptoms compared to other antipsychotics.

Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics

Tardive Dyskinesia is a disorder marked by uncontrollable movements of the face, tongue, and limbs caused by long-term antipsychotic drug usage. It is most often related with first-generation antipsychotics, although it may also occur with second-generation psychiatric drugs such as aripiprazole. Long-term antipsychotic usage and advanced age are considered to increase the likelihood of developing tardive dyskinesia.

Acute dystonia is adverse effect of antipsychotic medications that can occur shortly after starting treatment. It is characterized by involuntary muscle contractions, often in the face, neck, and back. Acute dystonia can be treated with anticholinergic medications or by reducing the dose of the antipsychotic medication (Bartram et al., 2019). Athetosis is a condition characterized by slow, writhing movements of the limbs and body. It can occur as a side effect of antipsychotic medications but is relatively rare. Tics are sudden, rapid, repetitive movements or sounds that are not necessarily related to the context of the situation. They can occur as a side effect of some medications, including antipsychotics.

Marta Garcia Diaz

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Antipsychotic Medication: Haloperidol

Haloperidol is a first-generation antipsychotic medication that is primarily used to treat psychotic disorders such as schizophrenia and delusional disorder. It is available in several forms, including oral tablets, injectable solutions, and long-acting injections. Haloperidol works by blocking dopamine receptors in the brain, which reduces the activity of dopamine, a neurotransmitter that is associated with psychosis.

The dosing of haloperidol depends on the patient’s age, weight, and condition being treated. It is usually started at a low dose and gradually increased to the target dose. The oral form of haloperidol is usually taken once or twice a day, while the injectable form is administered every few weeks (Rahman et al., 2022). Potential side effects of haloperidol include movement disorders such as parkinsonism, akathisia, and dystonia, as well as sedation, weight gain, and cardiovascular effects. 

Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics

Tardive dyskinesia is a movement disorder that can occur as adverse effect of long-term use of antipsychotic medications, including haloperidol. It is characterized by repetitive, involuntary movements of the face, tongue, and other body parts. It can be irreversible, even after discontinuing the medication. Acute dystonia is another movement disorder that can occur as a side effect of antipsychotic medication use (Beach et al., 2020). It is characterized by sustained muscle contractions, which can cause abnormal postures and movements. 

Athetosis is a movement disorder that is characterized by slow, writhing movements of the limbs, face, and torso. It can occur as a side effect of antipsychotic medication use, but is less common than tardive dyskinesia or acute dystonia. Tics are sudden, repetitive movements or vocalizations that can occur as a result of several conditions, including Tourette syndrome and some neurological and psychiatric disorders. They are different from other movement disorders in that they are usually not sustained and are often preceded by an urge or sensation.

Conclusion

Haloperidol is a first-generation antipsychotic medication that is used to treat psychotic disorders. It works by blocking dopamine receptors in the brain, but can cause several potential side effects, including movement disorders such as tardive dyskinesia, acute dystonia, athetosis, and tics. These movement disorders differ in their characteristics and underlying mechanisms, but all can be problematic for patients who are taking antipsychotic medications. Healthcare providers should be aware of the risks associated with these medications and monitor patients closely for potential side effects.

 
 

 
Marta Garcia Diaz

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Antipsychotic Medication: Risperidone

Risperidone is an atypical antipsychotic medication used for the treatment of schizophrenia, bipolar disorder, and irritability associated with autism. It works by blocking dopamine and serotonin receptors in the brain. Risperidone has a half-life of 20 hours and is metabolized by the liver (May et al., 2019). The dosing of risperidone depends on the condition being treated, but generally, it is started at a low dose and gradually increased to minimize side effects.

Potential Side Effects

The most adverse side effects of risperidone include sedation, weight gain, and metabolic changes, such as high blood sugar and high cholesterol levels. Other potential adverse effects include dry mouth, constipation, and blurred vision. Risperidone can also cause extrapyramidal symptoms, which include acute dystonia, akathisia, and Parkinsonism.

Mechanism of Action and Receptors Affected

Risperidone, a kind of antipsychotic medication developed in the 1990s, functions by competitively inhibiting both dopamine and serotonin receptors. Specifically, it blocks the D2 and 5-HT2A receptors (May et al., 2019). By blocking these receptors, risperidone decreases the activity of dopamine and serotonin in the brain, which reduces the symptoms of psychosis.

Comparison of Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics

They are all movement disorders that can occur as a side effect of antipsychotic medication. However, they differ in their symptoms and timing. Tardive dyskinesia is a condition that involves involuntary movements of the face, tongue, and limbs. It usually occurs after prolonged use of antipsychotic medication, and the symptoms can persist even after the medication is discontinued. 

Acute dystonia is a condition that involves muscle spasms and cramps, particularly in the neck, face, and tongue. It usually occurs shortly after starting antipsychotic medication, and the symptoms can be relieved by lowering the dose of the medication (Alkharboush et al., 2020). Athetosis is a condition that involves slow, writhing movements of the limbs. It is a rare adverse effect of antipsychotic medication that usually occurs after prolonged use. Tics are sudden, repetitive movements or sounds that are uncontrollable. 

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Leodan Diaz

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Antipsychotic Medication: Olanzapine

Olanzapine is an atypical antipsychotic medication that is commonly used in the treatment of psychotic disorders such as schizophrenia and bipolar disorder. It works by blocking the receptors for several neurotransmitters, including dopamine and serotonin, in the brain (Keating et al., 2021). The recommended starting dose for olanzapine is typically 5-10mg per day, with a maximum daily dose of 20mg. 

Olanzapine is available in several different formulations, including tablets, orally disintegrating tablets, and injectable formulations for intramuscular use. Like other antipsychotic medications, olanzapine can cause a range of potential adverse effects. Some of the most common adverse effects include weight gain, sedation, and dizziness. Olanzapine can also cause metabolic changes, including an increase in blood sugar levels and cholesterol levels.

Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics

Tardive Dyskinesia is a disorder marked by uncontrollable movements of the face, lips, jaw, and limbs. It can be a potentially irreversible side effect of long-term treatment with antipsychotic medications. Acute Dystonia is a condition characterized by involuntary muscle contractions, often of the face, neck, and tongue (Nowrouzi et al., 2021). It typically occurs within the first few days of starting antipsychotic treatment and can be treated with anticholinergic medications.

Athetosis is a condition characterized by slow, writhing movements of the limbs and fingers. It is a less common side effect of antipsychotic treatment. Tics are sudden, repetitive, and involuntary movements or sounds that can occur with antipsychotic use. Tics may be mild and easily managed or can be more severe and require treatment.

Conclusion

Olanzapine is an effective antipsychotic medication commonly used in the treatment of psychotic disorders. However, like other antipsychotic medications, it can cause a range of potential side effects, including metabolic changes and movement disorders such as tardive dyskinesia, acute dystonia, athetosis, and tics. Patients and their caregivers should be aware of these potential side effects and discuss them with their healthcare provider to ensure the benefits of treatment outweigh the risks.

 
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Esdena Lacina

20 hours ago, at 9:44 PM

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Antipsychotic Medication: Quetiapine

Quetiapine is an atypical antipsychotic medication used to treat psychotic disorders, including schizophrenia and bipolar disorder. The medication is administered orally and has a half-life of approximately six hours (Iqbal et al., 2019). The mechanism of action of quetiapine is through its antagonistic effect on dopamine and serotonin receptors in the brain, specifically the D2 and 5-HT2A receptors.

The potential side effects of quetiapine include weight gain, sedation, dry mouth, dizziness, and blurred vision. In rare cases, the medication can cause hyperglycemia, neuroleptic malignant syndrome, or agranulocytosis. Patients taking quetiapine should be monitored for changes in mood or behavior, as the medication can increase the risk of suicidal thoughts and behaviors (Iqbal et al., 2019). The dosing of quetiapine varies depending on the condition being treated and the patient’s response to the medication. Typically, the starting dose is 25-50mg per day, and the dose can be increased gradually up to a maximum of 800mg per day.

Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics

They are all movement disorders that can be associated with the use of antipsychotic medications. Tardive Dyskinesia is a disorder characterized by involuntary movements of the face and limbs that can be irreversible. Acute Dystonia is a condition that occurs shortly after starting an antipsychotic medication and is characterized by muscle spasms and cramping (Modesto-Lowe et al., 2021). Athetosis is a condition that affects the hands and fingers, causing involuntary movements and writhing. Tics are involuntary muscle contractions, typically of the face or neck.

The difference between these conditions lies in their presentation and timeline. Tardive Dyskinesia is a chronic condition that develops over months or years, while Acute Dystonia typically presents within hours or days of starting an antipsychotic medication (Modesto-Lowe et al., 2021). Athetosis is a rare condition that typically presents in childhood and is associated with cerebral palsy. Tics can be a symptom of several conditions, including Tourette’s Syndrome, and are typically seen in childhood or adolescence.

Conclusion

Quetiapine is an atypical antipsychotic medication used to treat psychotic disorders. Patients taking quetiapine should be monitored for changes in mood or behavior. Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics are all movement disorders that can be associated with the use of antipsychotic medications, but they differ in their presentation and timeline. Therefore, it is essential to monitor patients taking antipsychotic medications for any adverse effects and to adjust their treatment as needed.

 

Elizabeth Gonzalez

20 hours ago, at 9:38 PM

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Question 1

Clozapine is an antipsychotic medication used to treat schizophrenia and other psychotic disorders. It is usually prescribed when other antipsychotics have failed to show a satisfactory response (Chakrabarti, 2021). The most common side effects of clozapine include sedation, dizziness, constipation, dry mouth, weight gain, and increased risk of diabetes. Other more serious side effects include seizures, agranulocytosis, and increased risk of death in elderly patients with dementia-related psychosis.

Clozapine is usually prescribed in an initial dose of 25 mg to 50 mg taken orally once daily. The dose can then be gradually increased to a maximum of 900 mg per day (Chakrabarti, 2021). Clozapine is a dopamine antagonist that works by blocking the dopamine receptors in the brain. This reduces the effects of dopamine, which is thought to be involved in the symptoms of psychosis.

Clozapine blocks the dopamine D1, D2, D3, D4, and D5 receptors in the brain (Al Abadey et al., 2022).  It also blocks serotonin 5HT1A, 5HT2A, 5HT2C, and 5HT3 receptors . Clozapine also blocks histamine H1, muscarinic M1, and alpha-1 and alpha-2 adrenergic receptors.

Question 2

Tardive dyskinesia, acute dystonia, athetosis, and tics are all movement disorders that can be caused by various factors. Tardive dyskinesia is a neurological disorder that results in involuntary movements of the face and body, often as a result of the long-term use of dopamine-blocking medications. Acute dystonia is a sudden and painful muscle spasm that can occur as a side effect of antipsychotic drugs or other medications (Rashidpour et al., 2021).

Athetosis is a condition that causes slow, writhing movements of the hands, feet, and face. It is often associated with cerebral palsy and other neurological disorders (Miller, 2020). Tics are sudden, repetitive, non-rhythmic movements or sounds, such as eye blinking, facial grimacing, or throat clearing. They can be a symptom of Tourette syndrome or other tic disorders.

While these conditions all involve abnormal movements, they differ in their causes, symptoms, and treatments. Tardive dyskinesia and acute dystonia are both caused by medications, while athetosis and tics can be caused by a variety of neurological disorders. In terms of symptoms, tardive dyskinesia and athetosis both involve slow, writhing movements, while acute dystonia and tics involve sudden, jerking movements.

Treatment options also differ depending on the condition. Tardive dyskinesia may be treated by discontinuing the medication causing the symptoms or by using medications that target the specific symptoms. Acute dystonia is typically treated with anticholinergic medications, while athetosis may require physical therapy or surgery. Tics can be managed with medications or behavioral therapy.

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