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Antipsychotics in the Treatment of Mood Disorders and Risk of Tardive Dyskinesia

Paul E. Keck, Jr., MD; Susan L. McElroy, MD; Stephen M. Strakowski, MD; and Cesar A. Soutullo, MD

Published: April 30, 2000

Article Abstract

Psychosis occurs commonly in patients with mood disorders and has traditionally been treatedwith typical antipsychotics. Exposure to typical antipsychotics poses a risk for the emergence of tardivedyskinesia. Atypical antipsychotics may have advantages over typical agents in the treatment ofpatients with mood disorders complicated by psychotic features. The studies of typical and atypicalantipsychotics in the treatment of mood disorders were reviewed. Similarly, studies regarding the riskof tardive dyskinesia from typical and atypical agents in patients with mood disorders were surveyed.Typical and atypical antipsychotics appear to be comparably effective in the treatment of acute mania.Limited data regarding these medications in psychotic depression are available. Advantages of atypicalantipsychotics include, for most agents, minimal extrapyramidal and prolactin effects, inherentthymoleptic activity, and lower rates of tardive dyskinesia. Atypical antipsychotics appear to have anumber of advantages over typical agents in the treatment of patients with psychotic mood disorders.

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