Tardive dyskinesia in a South Asian population with first episode psychosis treated with antipsychotics.

BACKGROUND: Tardive dyskinesia (TD) is a side effect of antipsychotic treatment that often only appears after months or years of treatment. A systematic review of randomized controlled trials lasting more than 1 year showed that second-generation antipsychotics (SGAs) were associated with an approximately fivefold lower risk of TD compared to haloperidol in patients with chronic schizophrenia. In contrast, there is little research on the risk of TD with other first-generation antipsychotics (FGAs), and this applies especially to their use in the treatment of patients with first episode psychosis (FEP). OBJECTIVES: To determine the severity and point prevalence of TD in a naturalistic sample of patients with FEP in Pakistan treated with FGAs or SGAs. METHODS: This was an observational study. TD was assessed by trained clinicians using the Abnormal Involuntary Movement Scale. RESULTS: In the total sample (number =86) the mean age of patients was 26 years and the prevalence of TD (Schooler Kane criteria) was 29% with no significant difference between those treated with FGAs and SGAs (31% FGAs versus 26% SGAs; P=0.805). The Abnormal Involuntary Movement Scale total score (items 1-7), a measure of the severity of TD, was significantly higher for patients treated with FGAs versus those treated with SGAs (P=0.033). Scores on specific items showed that this reflected higher scores for dyskinesia affecting the muscles of facial expression, as well as of the upper and lower limb, whereas scores did not differ significantly in other body areas. CONCLUSION: FGAs were associated with greater severity, though not prevalence, of TD than SGAs. The study highlights the relatively high rate of TD in Asian FEP patients and the need for clinicians to monitor for this and other potential antipsychotic side effects during treatment.

Amino terminal, but not the carboxy terminal, sequences of tropomyosin-1 are essential for the induction of stress fiber assembly in neoplastic cells.

The presence of aberrant cytoskeleton, arising from the downregulation of key cytoskeletal proteins such as tropomyosins (TMs), is a prominent feature of many malignant cells and is suggested to promote neoplastic growth. While our previous work demonstrated that tropomyosin-1 (TM1) promotes stress fiber assembly and suppresses malignant growth, the molecular basis of the anti-oncogenic effects of TM1 has not been determined. By employing chimeric TMs, here we demonstrate that the amino terminal portion of TM1, but not the carboxy terminal portion which contains the alternatively spliced exon-coded sequences, is essential for stress fiber assembly and suppression of malignant growth. These studies also indicate that the amino and carboxy termini of TM1 coordinately function to regulate microfilament organization during cytokinesis.