Overcoming barriers to effective management of tardive dyskinesia

Tardive dyskinesia (TD) is a heterogeneous syndrome of involuntary hyperkinetic movements that is often persistent and occurs belatedly during treatment with antipsychotics. Recent approval of two dopamine-depleting analogs of tetrabenazine based on randomized controlled trials offers an evidence-ba...

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Bibliographic Details
Published in:Neuropsychiatric disease and treatment 2019-04, Vol.15, p.785-794
Main Author: Caroff, Stanley N
Format: Article
Language:English
Subjects:
Antipsychotic agents
Antipsychotics
Bias
Bipolar disorder
Caregivers
Chronic illnesses
Depression (Mood disorder)
Deutetrabenazine
Development and progression
Diagnosis
Dopamine
Drug-induced dyskinesia
drug-induced movement disorders
Drugs
Dyskinesia
Emotional disorders
Evidence-based medicine
Health aspects
Major depressive disorder
Mental disorders
Movement disorders
Neurophysiology
Neurosciences
Patients
Periodical publishing
Phenols (Class of compounds)
Prejudice
Prescription writing
Psychiatry
Psychotropic drugs
Review
Schizophrenia
Systematic review
tardive dyskinesia
Tetrabenazine
Time
Valbenazine
Vesicular monoamine transporter inhibitors
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Description
Summary:Tardive dyskinesia (TD) is a heterogeneous syndrome of involuntary hyperkinetic movements that is often persistent and occurs belatedly during treatment with antipsychotics. Recent approval of two dopamine-depleting analogs of tetrabenazine based on randomized controlled trials offers an evidence-based therapeutic approach to TD for the first time. These agents are optimally used within the context of a comprehensive approach to patient management that includes a practical screening and monitoring program, sensitive and specific criteria for the diagnosis of TD, awareness of the severity and impact of the disorder, informed discussions with patients and caregivers, and a rational basis for prescribing decisions about continued antipsychotic and adjunctive agents. Areas of limited or inconclusive data, bias and misunderstandings about key aspects, and neglect of training about TD in recent years contribute to barriers in providing effective care and promoting patient safety.
ISSN:1176-6328
1178-2021
1178-2021
DOI:10.2147/NDT.S196541