Tardive dyskinesia: Difference between revisions
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==Background== | ==Background== | ||
* | |||
==Clinical Features== | |||
*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: | |||
**Longer duration of neuroleptic treatment | |||
**Concomitant mood disorder | |||
**Patient age, particularly elderly females | |||
==Evaluation== | |||
*Clinical diagnosis | |||
==Differential Diagnosis== | |||
*See DDX for [[chorea]] | |||
==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 | |||
**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== | |||
*[[Seizure]] | |||
== | ==References== | ||
<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 | *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 | ||
[[Category: | [[Category:Neurology]] |
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