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Revisiting Tardive Dyskinesia: Focusing on the Basics of Identification and Treatment
Overview
What should you rule out to diagnose tardive dyskinesia (TD)? How do treatment options differ? In this journal CME activity, Drs Citrome and Saklad team up to review the best clinical strategies.
Abstract
The use of second-generation antipsychotics has not eliminated tardive dyskinesia (TD), and the prevalence of the disorder is higher than commonly realized. The involuntary movements of TD can decrease patients’ quality of life, cause embarrassment, and lead to social withdrawal. Clinicians must evaluate patients taking DRBAs for TD risk factors and regularly screen them for TD using a rating scale. Familiarity with tools and diagnostic criteria will enable clinicians to conduct a differential diagnosis. Once a diagnosis is made, medications approved by the US Food and Drug Administration can be used to treat the condition. These medications are effective, but clinicians should be aware of key differences. A baseline assessment and regular follow-up evaluations will allow the clinician to monitor the patient’s progress and make adjustments to meet treatment goals.
From the Series: Revisiting Tardive Dyskinesia: Focusing on the Basics of Identification and Treatment
To cite: Citrome L, Saklad SR. Revisiting tardive dyskinesia: focusing on the basics of identification and treatment. J Clin Psychiatry. 2020;81(2):TV18059AH3C.
To share: https://doi.org/10.4088/JCP.TV18059AH3C
© Copyright 2020 Physicians Postgraduate Press, Inc.
Target Audience
- Psychiatrists
- Neurologists
- Nurse Practitioners
- Physician Assistants
Learning Objectives
- Recognize risk factors for TD in patients being treated with antipsychotics
- Evaluate patients for TD at recommended intervals with standardized tools and criteria
- Review TD treatment options to select the most appropriate agent for each patient
Support Statement
Supported by an educational grant from Teva Pharmaceuticals.
CME Background
This Academic Highlights section of The Journal of Clinical Psychiatry presents the highlights of the teleconference series "Revisiting Tardive Dyskinesia: Focusing on the Basics of Identification and Treatment," which was held in July and August 2019. This report was prepared and independently developed by the CME Institute of Physicians Postgraduate Press, Inc., and was supported by an educational grant from Teva Pharmaceuticals.
The program was chaired by Leslie L. Citrome, MD, MPH, Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla. The faculty also included Stephen R. Saklad, PharmD, BCPP, Pharmacotherapy Division, The University of Texas at Austin College of Pharmacy, and Pharmacotherapy Education and Research Center, School of Medicine, UT Health San Antonio.
CME Objective
After studying this article, you should be able to:
- Recognize risk factors for TD in patients being treated with antipsychotics
- Evaluate patients for TD at recommended intervals with standardized tools and criteria
- Review TD treatment options to select the most appropriate agent for each patient
Release, Expiration, and Review Dates
This educational activity was published in February 2020 and is eligible for AMA PRA Category 1 Credit™ through April 30, 2022. The latest review of this material was January 2020.
Review Process
The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer who is without conflict of interest.
The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the supporter.
Disclosure of off-label usage
The chair has determined that, to the best of his knowledge, the only interventions that are approved by the US Food and Drug Administration for the treatment of tardive dyskinesia are valbenazine and deutetrabenazine.
Faculty Affiliation
Leslie L. Citrome, MD, MPH
Henry Ford Hospital Sleep Center and Department of Psychiatry, Wayne State University School of Medicine, Detroit, and Department of Psychiatry, University of Michigan College of Medicine, Ann Arbor
Stephen R. Saklad, PharmD, BCPP
Sleep Disorders Clinical Research Program and Departments of Psychiatry and Neurology, Massachusetts General Hospital, and Department of Psychiatry, Harvard Medical School, Boston
Financial Disclosure
All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past year, Marlene P. Freeman, MD, Editor in Chief of The Journal of Clinical Psychiatry, has received research funding from JayMac and Sage; has been a member of the advisory boards for Otsuka, Alkermes, and Sunovion; has been a member of the Independent Data Safety and Monitoring Committee for Janssen; has been a member of the Steering Committee for Educational Activities for Medscape; and, as a Massachusetts General Hospital (MGH) employee, works with the MGH National Pregnancy Registry, which is sponsored by Teva, Alkermes, Otsuka, Actavis, and Sunovion, and works with the MGH Clinical Trials Network and Institute, which receives research funding from multiple pharmaceutical companies and the National Institute of Mental Health. No member of the CME Institute staff reported any relevant personal financial relationships.
Dr Citrome is a consultant for Acadia, Alkermes, Allergan, Avanir, BioXcel, Eisai, Impel, Indivior, Intra-Cellular Therapies, Janssen, Lundbeck, Luye, Merck, Neurocrine, Noven, Osmotica, Otsuka, Pfizer, Sage, Shire, Sunovion, Takeda, Teva, and Vanda; is a member of the speaker bureaus for Acadia, Alkermes, Allergan, Janssen, Lundbeck, Merck, Neurocrine, Otsuka, Pfizer, Sage, Shire, Sunovion, Takeda, and Teva; and is a stock shareholder of Bristol-Myers Squibb, Eli Lilly, Johnson & Johnson, Merck, and Pfizer. Dr Saklad is a consultant for Texas Health and Human Services, San Antonio State Hospital, Alkermes, Genomind, Intra-Cellular Therapies, and Otsuka; has received grant/research support from Alkermes; and is a member of the speakers/advisory boards for Alkermes and Neurocrine.
Accreditation Statement
The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.
Available Credit
- 1.00 AMA PRA Category 1 Credit™
- 1.00 Participation