In this video, Dr. Craig Chepke underscores the importance of distinguishing tardive dyskinesia (TD) from other movement disorders to ensure proper treatment. While increased awareness of TD is promising, over-diagnosing all abnormal movements as TD can lead to errors. TD typically develops months or years after starting dopamine receptor antagonists, presenting as slow, non-rhythmic, dance- or worm-like movements. In contrast, drug-induced Parkinsonism often occurs soon after medication changes and features rhythmic tremors, such as pill-rolling hand movements or rabbit lip tremors, along with bradykinesia.

Dr. Chepke emphasizes assessing the whole patient, noting that Parkinsonism often includes reduced overall movement, such as minimal facial expression and a lack of arm swing, while TD presents with normal or excessive movements. Accurate diagnosis is critical, as treatments for one disorder can worsen the other. VMAT2 inhibitors, effective for TD, may exacerbate Parkinsonism, while anticholinergics like benztropine, used for Parkinsonism, can worsen TD.

Reference: Chepke C. Differential Diagnosis of Tardive Dyskinesia and Drug-Induced Parkinsonism. HMP Global Learning Network. Published July 2, 2024. Accessed November 14, 2024. https://www.hmpgloballearningnetwork.com/site/pcn/videos/differential-diagnosis-tardive-dyskinisia-and-drug-induced-parkinsonism