Oral dyskinesia

Rosengarten H, Schweitzer JW, Friedhoff AJ. A mechanism underlying neuroleptic induced oral dyskinesias in rats. Pol J Pharmacol 1993 45(4) 391-398. 

Hashimoto T, Ross DE, Gao XM, Med-off DR, Tamminga CA. Mixture in the distribution of haloperidol-induced oral dyskinesias in the rat supports an animal model of tardive dyskinesia. Psychopharmacology (Berlin) 1998 137(2) 107-112. 

Barthalmus, G. T. and Zielinski, W. J. (1988). Xenopus skin mucus induces oral dyskinesias that promote escape from snakes. Pharmacology,BiochemisttyandBehavior30,957-959. 

While the precise importance of Dj and D2 receptors in the clinical effects of neuroleptics is still uncertain, there is experimental evidence from studies in primates that oral dyskinesia (which may be equivalent to tardive dyskinesia in man) is related to an imbalance in Dj and D2 receptor function, the dyskinesia arising from a relative overactivity of the D receptors. Thus the elucidation of the precise function of these receptor subtypes may be important not only in determining the mode of action of neuroleptics but also in understanding their side effects. 

Edwards, H. (1970). The significance of brain damage in persistent oral dyskinesia. British Journal of Psychiatry, 116, 271-275. 

Varga E, Sugarman AA, Varga V, Zomorodi A, et al. Prevalence of spontaneous oral dyskinesia in elderly persons. 12th CINP Congress, Gothenburg 1980 . 

Oral dyskinesia emerged after several months of treatment with haloperidol 7.5 mg/day and gradually disappeared within 2 months after therapy was changed to aripiprazole 10 mg/day (6). 

The combination of clozapine and lithium has been examined in 44 patients (298). Medical records were retrospectively audited and a subsample of 23 patients was reassessed. The mean total duration of combination treatment was 23 months, and the combination was rated as effective in 84% however, there were adverse effects in 64%, most often fatigue (32%), hypersalivation (14%), and, in 7% of patients, orthostatic dysregulation, muscle fatigue, weight gain, and oral dyskinesias. 

Multiple involuntary movements, consisting of jaw grinding, oral dyskinesias, bilateral hand rolling, vermiform tongue movements, and bilateral choreiform movements of the digits, have been described in an 11-year-old boy taking thioridazine 150 mg/day and methylphenidate 10 mg bd (36). The methylphenidate was discontinued and within 4 weeks his movement disorder had completely disappeared. 

Fahn, S., David, E. 1973 Oral Dyskinesia Secondary to Anticholinergic Drugs. Excerpt. Med. Internat. Congr. 

It seems probable that the anticholinergic activity of antihistamine agents centrally alter nigrostriatal cholinergic-dopaminergic interaction and thereby produce acute and chronic oral dyskinesia. In patients with markedly severe acute dystonia induced by antihistamines, an intramuscular or intravenous trial of the centrally active cholinomimetic, physostigmine, might prove therapeutic. 

A 19-year-old male reported a case of oral dyskinesia due to methylphenidate (Ritalin) intoxication (60 mg) [27 ]. 

In a review of literature the specificity of the relationship between the administration of phenothiazine drugs and the occurrence of oral dyskinesias is called into question. A direct relationship between the administration of the drugs and the appearance of the syndrome, as is seen in drug-induced parkinsonism, is clearly not present. An indirect relationship, as might exist if the administration of the drugs produced the syndrome only in the presence of other fac-... 

For some further discussion on the oral dyskinesias, which have also occurred with drugs used for their antihistaminic properties, the reader is referred to Chapter 15. 

In 1973 Worz described a case of a 60-year-old woman in whom oral dyskinesia developed after prolonged use of a non-phenothiazine antihistamine mehydro-lin(25 ). Thach et al. 9 ) described 2 cases of oral facial dyskinesia associated with prolonged use of antihistamine decongestants, which must be briefly discussed here, since the drugs involved are very widely used, often for trivial indications. 

---