Tardive dyskinesia: Difference between revisions

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==Background==
==Background==
==Clinical Features==
*Orofacial involuntary movements
*Orofacial involuntary movements
**Described as grimacing, writhing and choreathetoid
**Described as grimacing, writhing and choreathetoid
**Grimacing, Tongue movements, Lip smacking, Excessive eye blinking
**Grimacing, tongue movements, lip smacking, excessive eye blinking
*Often occurs after years of treatment with neuroleptic agents
*Often occurs after years of treatment with [[antipsychotics|neuroleptic agents]]
*Risk factors:
*Risk factors:
**Longer duration of neuroleptic treatment
**Longer duration of neuroleptic treatment
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==Management==
==Management==
*Mild Symptoms: Cessation of the neuroleptic drug or decreasing the dose, which rarely reverses symptoms
*Mild symptoms: cessation of the neuroleptic drug or decreasing the dose, which rarely reverses symptoms
*Moderate to Severe Symptoms: Reserpine and tetrabenazine
*Moderate to severe symptoms: reserpine and tetrabenazine
*New drug approved 2017
*New drug approved 2017
**Austedo ([[deutetrabenazine]]), previously approved for chorea due to Huntington's disease
**Austedo ([[deutetrabenazine]]), previously approved for chorea due to Huntington's disease

Latest revision as of 16:36, 3 October 2019

Background

Clinical Features

  • Orofacial involuntary movements
    • Described as grimacing, writhing and choreathetoid
    • Grimacing, tongue movements, lip smacking, excessive eye blinking
  • Often occurs after years of treatment with neuroleptic agents
  • Risk factors:
    • Longer duration of neuroleptic treatment
    • Concomitant mood disorder
    • Patient age, particularly elderly females

Evaluation

  • Clinical diagnosis

Differential Diagnosis

Management

  • Mild symptoms: cessation of the neuroleptic drug or decreasing the dose, which rarely reverses symptoms
  • Moderate to severe symptoms: reserpine and tetrabenazine
  • New drug approved 2017
    • Austedo (deutetrabenazine), previously approved for chorea due to Huntington's disease
    • 12-48 mg/day PO divided BID, starting at 6 mg BID, increased by 6 mg/day qwk

See Also

References

  • Hockberger RS, Richards JR: Thought Disorders; in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2014, (Ch) 110: p 1460-1466