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Printable Handouts
Navigable Slide Index
- Introduction
- Learning objectives
- What is tardive dyskinesia (TD)?
- What are the signs or phenomenology of TD?
- How can you prevent TD?
- How often does TD occur?
- How long are patients at risk?
- How soon are patients at risk? TD is not always tardive
- Who is at risk for TD?
- Treatment factors that increase TD risk
- How to screen for TD
- Tips for brief screening
- How does TD affect patients and caregivers?
- How TD interferes with everyday life
- What about diagnostic criteria for TD?
- Should other diagnoses be considered?
- Differentiating TD and drug-induced Parkinsonism
- What is an effective treatment plan when TD occurs?
- How do antipsychotic modifications affect TD (1)?
- Maintaining antipsychotics in psychotic patients despite TD
- How do antipsychotic modifications affect TD (2)?
- Effect on TD of switching SGAs
- How do antipsychotic modifications affect TD (3)?
- What about anticholinergics?
- Vesicular monoamine transporter-2 inhibitors (VMAT2) deplete dopamine
- Tetrabenazine
- Binding properties of valbenazine
- Valbenazine randomized controlled trials
- Pharmacokinetic properties of deutetrabenazine
- Deutetrabenazine randomized controlled trials
- Prescribing VMAT2 Inhibitors
- What are clinically meaningful measures of response?
- What if a VMAT2 inhibitor fails?
- Key summary points
- Thank you!
Topics Covered
- Tardive dyskinesia (TD)
- TD prevention
- TD risks
- Treatment factors that increase TD risk
- Screening for TD
- Diagnostic criteria for TD
- Antipsychotic modifications
- Tetrabenazine
- Valbenazine
- Deutetrabenazine
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Caroff, S.N. (2024, October 31). Advances in the diagnosis and treatment of tardive dyskinesia [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 6, 2024, from https://doi.org/10.69645/ILYK1283.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Emeritus Stanley N. Caroff has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Advances in the diagnosis and treatment of tardive dyskinesia
Published on October 31, 2024
48 min
Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms
Transcript
Please wait while the transcript is being prepared...
0:00
Good morning. My name is
Dr. Stanley N. Caroff.
I'm an Emeritus Professor at
the University of Pennsylvania,
Perelman School of
Medicine in Philadelphia,
Pennsylvania in
the United States.
I'll be talking
about advances in
the diagnosis and treatment
of tardive dyskinesia.
0:21
The learning objectives
today are to interpret
effective screening policies for
the early diagnosis of
tardive dyskinesia or TD,
including patient and
caregiver reports.
We'll also describe
the impact of TD on
functioning and quality
of life, and finally,
construct an individualized
treatment plan
for patients with TD, including
measures of response.
0:48
Now what is tardive
dyskinesia or TD?
I'm sure many of you are
already familiar with this.
TD is defined as an
involuntary, hyperkinetic
movement disorder that's delayed
in onset and potentially
irreversible
even after the triggering
drugs are discontinued.
The symptoms of TD
range in phenomenology,
severity, and impact.
Now, TD mostly affects
the orofacial region
in 60-80% of patients,
but two or more
body regions can be
involved in at least
half of the cases,
so it's important to examine
the entire patient's body.
TD is most often mild with
a total abnormal involuntary
movement scale score of
less than five in about
70-80% of patients,
but it can be moderate
or severe with an AIMS
greater than six in
20-30% of patients.
Now it's important to realize
that patients may have
two or more drug-induced
movement disorders
in as many as 20-30% of patients
who have a drug-induced
movement disorder.
For example, TD can also
occur with tardive dystonia
in 10% of cases in
one study and even with
the acute reversible
drug-induced movements of
parkinsonism and akathisia
in 13 or 5% respectively.