Expert Perspectives on Recognition and Management of Tardive Dyskinesia.

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Date: Aug. 2021
From: Psychiatric Times(Vol. 38, Issue 8)
Publisher: Intellisphere, LLC
Document Type: Article
Length: 953 words
Lexile Measure: 1550L

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Clinical experiences and insights in this Psychiatric Times[TM] Case-Based Psych Perspectives were shared by Leslie L. Citrome, MD, MPH, a psychiatry specialist from Valhalla, New York, and Rose Mary Xavier, PhD, MS, RN, PMHNP-BC, a research scientist and psychiatric nurse practitioner from Chapel Hill, North Carolina. This article provides a summary of key discussion topics from this custom program. Participant bios and financial disclosures are available online.

Xavier highlighted that antipsychotic medications are used for both primary psychotic disorders and mood disorders, including bipolar disorder, and as adjunctive treatment for major depressive disorder. Though the atypical antipsychotics commonly used today carry less risk for tardive dyskinesia (TD) than earlier agents, faculty agreed that the risk of TD remains significant with atypical agents. Citrome said that atypical antipsychotics block postsynaptic dopamine-2 receptors, the putative mechanism underlying the development of TD.

Treating TD is not as simple as stopping the antipsychotic agent, particularly if it is keeping a patient stable. "We need to look at interventions that allow us to continue ongoing treatment for the underlying psychiatric disorder. The option in my mind would be a VMAT2 inhibitor [vesicular monoamine transporter type-2 inhibitor], of which 2 are approved by the FDA for the treatment of tardive dyskinesia, which is added to the patient's ongoing regimen," said Citrome.

Symptom Recognition and Impact on Patients

Faculty cited some of the movements that are characteristic of classic TD: fingers moving as if playing...

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Gale Document Number: GALE|A676443368