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The APA’s Practice Guideline for the Treatment of Patients with Schizophrenia, 3rd Edition Demonstrates Relevance of TD Awareness and Treatment

By California Chronic Care Coalition

March 26, 2021

By Said Jacob, MD

Tardive dyskinesia (TD) might not be a well-known disorder, but understanding its diagnosis and treatment is crucial to helping those with mental health disorders maintain a healthy quality of life. The American Psychiatric Association’s inclusion of a section dedicated to the assessment and treatment of TD in the new edition of their Practice Guideline for the Treatment of Patients with Schizophrenia gets us one step closer to enabling a truly comprehensive education for mental health providers.

What is TD?

Tardive dyskinesia is a disorder that develops as a side effect of using any antipsychotic medication. The disorder is characterized by uncontrollable, stiff, jerky movements of the face or body.  A patient with TD might blink their eyes, stick out their tongue, or wave their arms without meaning to do so. These symptoms can often be severe and disruptive to daily life, and in many cases are irreversible without treatment.

Are there treatments for TD?

Thankfully, there are a few treatments that have recently been developed to treat adults with TD. These treatments, which are medically referred to as reversible inhibitors of VMAT2, have been associated with significant reductions in motor signs and symptoms of TD.

The Importance of TD Awareness in the Mental Health Community

Because TD occurs as a result of exposure to any antipsychotic medication, its proper diagnosis and treatment are crucial to bettering the health outcomes for the mental health community. Those who are at the highest risk for developing TD include individuals older than 55 years, women, individuals with a mood disorder, substance abuse disorder, intellectual disability, and those who have been treated for schizophrenia, bipolar disorder, or depression. In adult patients treated with first-generation antipsychotic agents, TD occurs at a rate of 4-8% per year. When we factor in the fact that 1 in 5 Americans has a mental illness, it becomes clear why it is so important that our providers are educated on how to spot and treat this disorder.

I am encouraged to see the APA reflect exciting new developments in neuropharmacology that allow TD to be treated effectively, improving lives for many who have struggled with mental health disorders over the course of their lifetime. The new guidelines are a step in the right direction as we continue to build awareness and knowledge of the complexities of treatment for mental health disorders.

Written by: Said Jacob, MD, Medical Director of Aurora Charter Oak Hospital in West Covina, Calfiornia