Study Reveals Comorbidities and Outcomes in Psychiatric Inpatients With Tardive Dyskinesia: Implications for Severe Illness and Healthcare Costs

Researchers of a study analyzed comorbidities and outcomes in psychiatric inpatients with tardive dyskinesia (TD). The study used a case-control design with data from the Nationwide Inpatient Sample, involving 77,022 adult inpatient admissions for mood disorders and schizophrenia. TD was found to be more common in older adults (50-64 years) and occurred in similar proportions among men and women. Patients with TD had a higher likelihood of cardio-metabolic comorbidities, including obesity, hypertension, and diabetes, compared with those without TD.

The researchers concluded that psychiatric inpatients with TD tend to have more severe illness, with those having schizophrenia and bipolar disorders being at the highest risk, and the presence of TD is associated with poorer hospital outcomes, including longer stays and higher costs for acute inpatient care.

Study Reveals Why Black Americans Face Higher Tardive Dyskinesia Risk

A study shows the increased risk of tardive dyskinesia (TD) among Black individuals in the United States compared with White individuals. The study identifies contributing factors, including health disparities and specific genetic traits in Black populations, which slow down the metabolism of drugs like antipsychotics, elevating TD risk. Moreover, the prescription pattern of first-generation antipsychotics, more strongly linked to TD, to Black Americans by doctors is highlighted. The researchers emphasize the importance of open communication between patients and healthcare providers, especially for those at risk, and highlight the critical role of monitoring medication usage, dosage, and treatment duration in TD symptom management.

Study Finds Patient Perception of Tardive Dyskinesia’s Impact Differs From Clinician Assessment

Researchers of a study examined the impact of tardive dyskinesia (TD) patient health and social functioning, conducted in two cohorts: Cohort 1 consisted of patients with no abnormal involuntary movements, while Cohort 2 consisted of patients with possible TD according to clinicians’ judgment. The assessments included measuring health utility using EuroQoL’s EQ-5D-5L, social functioning using the Sheehan Disability Scale (SDS), as well as patient- and clinician-rated severity and impact of TD.
The results showed that in Cohort 2, patient-rated TD impact was significantly associated with lower health utility and higher SDS scores. However, clinician-rated severity was moderately associated with both health utility and SDS, but these associations were not statistically significant. The study concluded that the severity of TD assessed by clinicians did not always correlate with patient perceptions of the significance of TD.

Link Between Antidepressants and Tardive Dyskinesia Explored

In a recent study, researchers critiqued various reviews and case reports associating non-dopamine-receptor-blocking drugs (DRBDs) with a tardive dyskinesia (TD) like syndrome, examining if the cases met TD criteria and excluded DRBD use. Their findings indicate that both tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitor antidepressants (SSRIs) may reveal or worsen TD in individuals previously exposed to or using DRBDs; however, they found minimal evidence supporting TD’s existence outside of this context.

Understanding Tardive Dyskinesia

The author of this article gives an overview of tardive dyskinesia (TD). TD can potentially be a permanent movement disorder that is caused by dopamine receptor blocking agents (DRBAs) in chronically using them. There are several risk factors associated with TD including certain genetic factors, female sex, African and Caucasian ethnicity, older age, illness duration along with cumulative dose of DRBA, and use of first-generation antipsychotics. Approximately 25% of psychiatric patients taking antipsychotic medication are estimated to have TD, representing a minority compared with the amount of people taking these medications. Prevention of TD is crucial, as stopping the medication causing TD does not always relieve the condition; however, there is no certain way to predict who will develop TD once starting DRBA use.

Authors Review Impact of Calcium Channel Blockers on Antipsychotic-Induced Tardive Dyskinesia

Authors of a review looked to study the impact of calcium channel blocker therapies (diltiazem, nifedipine, nimodipine, verapamil) in treating patients with neuroleptic-induced tardive dyskinesia (TD) and chronic mental illnesses including schizophrenia and schizoaffective disorder. Researchers used the Cochrane Schizophrenia Group Trials Register (July 2015 and April 2017) to gather information for their research. There were no trials included in prior versions of this review. In their 2015 review, there were three cross-over trials that were included by the researchers, but no new relevant studies in the 2017 review. A total of 47 patients were included in the study from the included trials who had chronic mental illness from both the United States and China. Authors did note that, due to the low availability of evidence, no conclusions could be made on the impact of calcium channel blockers in antipsychotic-induced TD.

Exploring the Dopamine-Based Pathophysiology of Tardive Dyskinesia

The leading theory on the pathophysiology of tardive dyskinesia (TD) is that chronic treatment with dopamine receptor-blocking agents (DRBAs) causes a “supersensitivity” of dopamine receptors in the dorsal striatum. Researchers have begun investigating beyond the supersensitization theory. Chronic DRBA treatment may contribute to oxidative stress caused by other mechanisms, and it is possible that damage to interneurons may be involved. The notion of genetic susceptibility when it comes to a diagnosis of TD after treatment with antipsychotics is discussed. 

Insights on Treating Tardive Dyskinesia Using Telehealth

A panel of six neurologists, three psychiatrists, and three psychiatric nurse practitioners participated in a study to outline a framework to address the use of telehealth to treat tardive dyskinesia. The panel found telehealth to be beneficial primarily for the ease of making and attending appointments for patients but agreed that an in-person assessment should be held at least every six months from telehealth appointments. Additional recommendations are discussed.