Video-Based Review: Differentiating Tardive Dyskinesia
It is important for an accurate diagnosis of tardive dyskinesia (TD), as well as a suitable treatment plan, as the symptoms of TD can be disruptive to both patients and caregivers. A misdiagnosis of TD can result in inaccurate interventions that may lead to harmful or poor outcomes. Researchers conducted a video-based review to help identify and differentiate TD in the psychiatric setting through looking at its clinical features and phenomenology, in addition to those of other antipsychotic-induced movement disorders. Movement phenomenology, current dose reduction or discontinuation of a dopamine-receptor blocking agent, and history of exposure to a dopamine-receptor blocking agent are how a differential diagnosis of TD is established. Challenges in diagnosing TD include other movement disorders that are linked to dopamine-receptor blocking agents, as well as abnormal behaviors and dyskinesias that are linked to older age or chronic mental illness. The duration of exposure can help in ruling out some drug-induced syndromes. Something else that the researchers note is to consider the possibility of TD presenting along with another drug-induced movement disorder. This can make diagnosis and management more complex in the same patient. Treatment options should be assessed with patients and their caregivers following documentation of the phenomenology, severity, and distribution of TD movements.
Reference: Hauser RA, Meyer JM, Factor SA, et al. Differentiating tardive dyskinesia: a video-based review of antipsychotic-induced movement disorders in clinical practice. CNS Spectr. 2022;27(2):208-217. doi:10.1017/S109285292000200X