Researchers of a study looked at the current knowledge regarding the pathophysiology of tardive dyskinesia (TD) to provide recommendations for prevention and treatment based on a literature search and a roundtable discussion with psychiatrists in Japan.

Most guidelines recommend managing TD by reducing antipsychotic doses, switching to clozapine or other second-generation antipsychotics with a lower association with TD, as well as focusing on prevention and monitoring when prescribing antipsychotics. TD is often irreversible, emphasizing the importance of cautious antipsychotic use at the lowest effective dose and frequent monitoring for TD symptoms. Another promising option is the use of vesicular monoamine transporter 2 (VMAT-2) inhibitors, which interfere with dopamine uptake and storage, counteracting the increased dopaminergic activity associated with prolonged antipsychotic use.

Reference: Takeuchi H, Mori Y, Tsutsumi Y. Pathophysiology, prognosis and treatment of tardive dyskinesia. Ther Adv Psychopharmacol. 2022;12:20451253221117313. doi:10.1177/20451253221117313