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, | **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 | ||
Line 16: | Line 18: | ||
==Management== | ==Management== | ||
*Mild | *Mild symptoms: cessation of the neuroleptic drug or decreasing the dose, which rarely reverses symptoms | ||
*Moderate to | *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
- See DDX for chorea
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