Tardive dyskinesia screening and treatment

Treat tardive dyskinesia (TD) while preserving your patient’s antipsychotic regimen1

Screen Regularly for TD

2020 American Psychiatric Association (APA) guidelines2

  • Screen for TD before starting or changing patients’ dopamine receptor blocking agent (DRBA) treatment
  • Monitor for signs of TD at every visit
  • Conduct structured TD assessment every 6 to 12 months, depending on patient’s risk, and if new or
    worsening movements are detected at any visit
  • Consider a diagnostic evaluation

TD may affect more than one area of the body—not just the face1

Identify patients with these signs and symptoms of TD in your practice.

Upper limbs

Asymmetrical movements, swaying, “piano fingers,” grabbing of clothing3,4

Lower limbs

Splayed or hyperextended toes, gripping, ankle twisting3,4

Torso

Hyperextension, shifting, rocking3,4

Tongue

“Bonbon” sign, protrusion, darting3,4

Eyes

Excessive blinking and squinting3,4

Lips

Smacking, puckering, pursing3,4

Jaw

Biting, clenching, lateral movements, chewing3,4

Not actual patients

Can you identify the differences between TD and acute
extrapyramidal symptoms (EPS)?

TREAT TD FIRST-LINE WITH VMAT2 INHIBITORS

Systematic review of evidence through 20185

LEVEL A RECOMMENDATION

Strongest recommendation, established as effective, based on at least 2 consistent class I studies

Selective VMAT2 inhibitors like INGREZZA® (valbenazine) capsules are established as effective treatments of TD and must be recommended as treatment

This 2018 practical treatment algorithm for suppressive agents can help you determine how to reduce your patients’ TD movements.5

PRESERVE STABLE ANTIPSYCHOTIC REGIMENS

2013 American Academy of Neurology (AAN) guidelines6

  • There is a lack of clear evidence to support or refute withdrawing or switching antipsychotics to treat TD
  • Changing a patient’s antipsychotic regimen may destabilize the underlying psychiatric condition

Watch expert perspective videos on screening and managing TD

Featuring Bryce Reynolds, MD

Using motivational interviewing to talk about tardive dyskinesia (TD)

Changing mindsets and behaviors for better tardive dyskinesia (TD) assessments

These videos were sponsored and developed by Neurocrine Biosciences. The speaker is a paid consultant of Neurocrine Biosciences.

Watch more expert perspectives on THE INGREZZA YOUTUBE CHANNEL

REFERENCES: 1. Hauser RA, Factor SA, Marder SR, et al. KINECT 3: a phase 3 randomized, double-blind, placebo-controlled trial of valbenazine for tardive dyskinesia. Am J Psychiatry. 2017;174(5):476-484. 2. Keepers GA, Fochtmann LJ, Anzia JM, et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. 3rd ed. American Psychiatric Association Publishing, 2020. https://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890424841. Accessed September 1, 2020. 3. Guy W. ECDEU Assessment Manual for Psychopharmacology. Revised 1976. Rockville, MD: National Institute of Mental Health; 1976. 4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013. 5. Bhidayasiri R, Jitkritsadakul O, Friedman JH, Fahn S. Updating the recommendations for treatment of tardive syndromes: a systematic review of new evidence and practical treatment algorithm. J Neurol Sci. 2018;389:67-75. 6. Summary of evidence-based guidelines for clinicians: treatment of tardive syndromes. American Academy of Neurology website. https://www.aan.com/Guidelines/Home/GetGuidelineContent/613. Published 2013. Accessed August 22, 2018.