Effets secondaires des médicamenst plus longs à disparaitre que prévu...

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[P04.031] Reversibility of Tardive Syndromes

Deepti Zutshi, Leslie Cloud, Stewart Factor, Atlanta, GA

OBJECTIVE: To evaluate the frequency and clinical predictors of reversibility of tardive syndromes (TS) in patients in whom the inciting agent was stopped. BACKGROUND: Tardive syndromes (TS) are often debilitating iatrogenic movement disorders caused by dopamine receptor blocking agents (DRBA). Estimates of reversibility are 30% but this varies and clinical predictors remain unclear. DESIGN/METHODS: We completed a retrospective study of 108 TS patients seen between January 2006 and December 2009. TS reversibility was the primary outcome of interest. Variables recorded included age, sex, ethnicity, primary diagnosis, presence of diabetes, history of alcohol abuse, offending agent, duration of exposure, TS type, baseline severity, and treatments used. The cohort was stratified on the basis of TS reversibility and student's t-tests and chi-squared tests were used for subgroup comparisons. Correlations between study variables were evaluated using Pearson's, Point- and Rank-Biserial correlation coefficients. Logistic regression was undertaken to identify clinical variables predictive of TD reversibility. RESULTS: The most common offending agents were GI DRBA (42%), atypical antipsychotics (36%), and typical antipsychotics (14%). Seventy-five of the subjects were female, mean age 58.6 years (SD +/- 17.7). The most common underlying diagnoses leading to DRBA use were mood disorder and GI illness (38% each) and 26% had classical dyskinesia, 23% dystonia. Fourteen subjects (13%) had complete resolution of the TS upon last follow-up. Subgroup analysis comparing subjects with and without resolution revealed no significant difference in any study variables. Reversibility was not correlated with any study variables (highest r<0.2). CONCLUSIONS: This cohort was unique in that all eliminated the offending agent. The frequency of reversibility was lower than previously reported. No clinical predictors of TD reversibility were identified. Inherent weaknesses of retrospective data collection may explain our results. Prospective studies are needed to assess predictors of TD reversibility.
Category - Movement Disorders: Tardive Dyskinesia and Paroxysmal Dyskinesia

Wednesday, April 25, 2012 7:30 AM

Session P04: Movement Disorders: Restless Legs Syndrome, and Tardive Dyskinesia (7:30 am-12:00 pm)


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les antibiotiques ont un effet transgénérationnel? Oui. Ce ne serait pas les pesticides combattus par Efa Choly qui seraient en cause?  Non et surtout il faut retenir que les faits expérimenatux et cliniques doivent être privilégiés par rapport aux idéologies...
"In this study, tetracycline had no detrimental consequences for
sperm number, female reproduction or body size in either sex. By
contrast, tetracycline-treated males exhibited significantly reduced
sperm viability, and transmitted this toxic effect of tetracycline on
sperm to their untreated sons but not to their F2 grandsons. The
transient nature of this paternally-inherited effect is consistent with
tetracycline-induced epigenetic changes in the male germline.
Exposure to epigenome-modifying agents during critical phases of
development can result in transmission of altered epigenetic states,
involving changes in DNA methylation, histone modifications or
non-coding RNAs, across one to several generations15" 

"The increasing evidence for pernicious effects of antibiotics on
spermatogenesis can provide a parsimonious explanation for the
marked decline in human ejaculate quality over the last 60 years27.
Although declining sperm density has generally been attributed to
increased exposure to pesticides and other endocrine disrupting chemicals28,
the onset of this decline29 also coincided with the introduction
and widespread use of antibiotics in the 1950s. In one of the few
studies that have statistically evaluated multiple factors potentially
contributing to male subfertility30, recent use of antibiotics, primarily
penicillin and doxycycline (a derivative of the tretracycline group),
outranked pesticide exposure, welding and smoking as the single
most significant risk factor for oligospermia (low sperm count).
Taken together, the results of animal and human studies indicate
that antibiotic use should be given serious consideration as a factor
contributing to human male subfertility, and that further investigation
of the direct and transgenerational effects of antibiotics on male
reproductive function in model organisms is clearly warranted."
http://www.nature.com/srep/2012/120426/srep00375/pdf/srep00375.pdf


Le corps humain n'est pas un réservoir qu'il suffirait de vider, filtrer... L'épigénome est influencé par TOUS LES INTRANTS!