Tardive dyskinesia: Prevention and newer management strategies
Tardive dyskinesia (TD) is a condition where we have a limited understanding of the cause and of management. The delayed-onset movements can occur due to prolonged exposure to dopamine receptor-blocking agents (DRBAs). They can be physically disabling and lead to ridicule and stigmatization. TD also...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Annals of Indian Psychiatry |
| Subjects: | |
| Online Access: | http://www.anip.co.in/article.asp?issn=2588-8358;year=2020;volume=4;issue=1;spage=10;epage=19;aulast=Vaidyanathan |
| _version_ | 1829138283203919872 |
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| author | Sreelakshmi Vaidyanathan Suyog Vijay Jaiswal |
| author_facet | Sreelakshmi Vaidyanathan Suyog Vijay Jaiswal |
| author_sort | Sreelakshmi Vaidyanathan |
| collection | DOAJ |
| description | Tardive dyskinesia (TD) is a condition where we have a limited understanding of the cause and of management. The delayed-onset movements can occur due to prolonged exposure to dopamine receptor-blocking agents (DRBAs). They can be physically disabling and lead to ridicule and stigmatization. TD also interferes with treatment adherence. The increased trend of prescriptions for off-label use of various DRBAs, especially antipsychotics, has increased the risk of TD. No currently available antipsychotic is free of the risk of TD, though the atypicals have a lower risk. The Abnormal Involuntary Movements Scale is the most widely used and recommended tool for the assessment and monitoring of TD. Varied treatment strategies have been tried including cessation of the DRBA, switch to a lower potency antipsychotic, and concomitant use of other medications such as clonazepam and Vitamin E. Most of these strategies have minimal evidence. The recent US Food and Drug Administration approval of two VMAT2 inhibitors, deutetrabenazine and valbenazine, for the treatment of TD has brought some relief to these patients. Cost may be a limiting factor in their use. Nonpharmacological treatment such as deep-brain stimulation, botulinum toxin, and electroconvulsive therapy is to be used only in intractable/incapacitating movements. Despite these newer options, the best strategy in the management of TD continues to be prevention. Judicious use of antipsychotics, regular monitoring of patients on DRBAs, and early diagnosis and intervention are strategies that significantly reduce the development of TD and improve the quality of life of patients. |
| first_indexed | 2024-12-14T19:14:01Z |
| format | Article |
| id | doaj.art-c1f206309ede41b792de9dbca05fd503 |
| institution | Directory Open Access Journal |
| issn | 2588-8358 2588-8366 |
| language | English |
| last_indexed | 2024-12-14T19:14:01Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Psychiatry |
| spelling | doaj.art-c1f206309ede41b792de9dbca05fd5032022-12-21T22:50:39ZengWolters Kluwer Medknow PublicationsAnnals of Indian Psychiatry2588-83582588-83662020-01-0141101910.4103/aip.aip_29_20Tardive dyskinesia: Prevention and newer management strategiesSreelakshmi VaidyanathanSuyog Vijay JaiswalTardive dyskinesia (TD) is a condition where we have a limited understanding of the cause and of management. The delayed-onset movements can occur due to prolonged exposure to dopamine receptor-blocking agents (DRBAs). They can be physically disabling and lead to ridicule and stigmatization. TD also interferes with treatment adherence. The increased trend of prescriptions for off-label use of various DRBAs, especially antipsychotics, has increased the risk of TD. No currently available antipsychotic is free of the risk of TD, though the atypicals have a lower risk. The Abnormal Involuntary Movements Scale is the most widely used and recommended tool for the assessment and monitoring of TD. Varied treatment strategies have been tried including cessation of the DRBA, switch to a lower potency antipsychotic, and concomitant use of other medications such as clonazepam and Vitamin E. Most of these strategies have minimal evidence. The recent US Food and Drug Administration approval of two VMAT2 inhibitors, deutetrabenazine and valbenazine, for the treatment of TD has brought some relief to these patients. Cost may be a limiting factor in their use. Nonpharmacological treatment such as deep-brain stimulation, botulinum toxin, and electroconvulsive therapy is to be used only in intractable/incapacitating movements. Despite these newer options, the best strategy in the management of TD continues to be prevention. Judicious use of antipsychotics, regular monitoring of patients on DRBAs, and early diagnosis and intervention are strategies that significantly reduce the development of TD and improve the quality of life of patients.http://www.anip.co.in/article.asp?issn=2588-8358;year=2020;volume=4;issue=1;spage=10;epage=19;aulast=Vaidyanathandrug-induced dyskinesiamovement disorderstardive dyskinesiavmat2 inhibitors |
| spellingShingle | Sreelakshmi Vaidyanathan Suyog Vijay Jaiswal Tardive dyskinesia: Prevention and newer management strategies Annals of Indian Psychiatry drug-induced dyskinesia movement disorders tardive dyskinesia vmat2 inhibitors |
| title | Tardive dyskinesia: Prevention and newer management strategies |
| title_full | Tardive dyskinesia: Prevention and newer management strategies |
| title_fullStr | Tardive dyskinesia: Prevention and newer management strategies |
| title_full_unstemmed | Tardive dyskinesia: Prevention and newer management strategies |
| title_short | Tardive dyskinesia: Prevention and newer management strategies |
| title_sort | tardive dyskinesia prevention and newer management strategies |
| topic | drug-induced dyskinesia movement disorders tardive dyskinesia vmat2 inhibitors |
| url | http://www.anip.co.in/article.asp?issn=2588-8358;year=2020;volume=4;issue=1;spage=10;epage=19;aulast=Vaidyanathan |
| work_keys_str_mv | AT sreelakshmivaidyanathan tardivedyskinesiapreventionandnewermanagementstrategies AT suyogvijayjaiswal tardivedyskinesiapreventionandnewermanagementstrategies |