Insights on Identifying and Managing Tardive Dyskinesia

In a Case-Based Psych Perspectives from Psychiatric Times, Leslie L. Citrome, MD, MPH, a psychiatry specialist, and Rose Mary Xavier, PhD, MS, RN, PMHNP-BC, a research scientist and psychiatric nurse practitioner, shared their clinical experiences and perspectives on the recognition, diagnosis, and management of tardive dyskinesia (TD). In recognizing symptoms, family members or case managers frequently report symptoms that include facial grimacing, random tongue protrusion, and shoulder shrugging. It was noted that patients with schizophrenia can become aware of these movements, and it may cause greater amounts of anxiety, paranoia, and social isolation, emphasizing that it is crucial to recognize the level of distress patients face from TD.

The “gold standard” for diagnosing TD is the Abnormal Involuntary Movement Scale, which helps to differentiate symptoms of TD from drug-induced parkinsonism and other drug-induced movement disorders. Treatment guidelines from the American Psychiatric Association advises the use of VMAT2 inhibitors for the treatment of moderate-to-severe TD. The experts concluded that a diagnosis of TD should be centered around a formal and structured evaluation of abnormal movements, and treatment should be based on how the symptoms are impacting the patient.

Reference: Expert Perspectives on Recognition and Management of Tardive Dyskinesia. Psychiatric Times. Published July 30, 2021. Accessed July 27, 2021.

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