Earlier Diagnosis of Tardive Dyskinesia
Do you proactively assess patients for tardive dyskinesia? Here, learn about screening and diagnosis from an expert.
Because the symptoms of tardive dyskinesia (TD) have an insidious onset and fluctuating nature, and the risk of TD associated with second-generation antipsychotic (SGA) treatment has been underestimated, it has been challenging for clinicians to make an early and accurate TD diagnosis. More patients are at risk of developing this potentially permanent, disabling condition than ever before because of the widespread use of SGAs; therefore, prevention of TD, if possible, is of utmost importance. Clinicians must use reliable screening tools and diagnostic criteria to assess patients for TD, rule out other abnormal movement conditions, and make an accurate TD diagnosis.
From the Series: Early Recognition and Treatment of Tardive Dyskinesia in Patients With Mood Disorders and Schizophrenia
To cite: Kremens DE. Earlier diagnosis of tardive dyskinesia. J Clin Psychiatry. 2020;81(1):NU18041BR1C.
To share: https://doi.org/10.4088/JCP.NU18041BR1C
© Copyright 2019 Physicians Postgraduate Press, Inc.
Psychiatrists, neurologists, nurse practitioners, and physician assistants
Recognize early signs of TD through regular screening and patient/family education about symptoms
Supported by an educational grant from Neurocrine Biosciences, Inc.
After completing this educational activity, you should be able to:
- Recognize early signs of TD through regular screening and patient/family education about symptoms
Release, Review, and Expiration Dates
This brief report activity was published in November 2019 and is eligible for AMA PRA Category 1 Credit™ through November 30, 2021. The latest review of this material was September 2019.
Statement of Need and Purpose
Because some clinicians underestimate the risk of TD, especially with newer antipsychotics, they do not advise patients and caregivers of the risk of TD or educate them about early signs to watch for and report. A substantial proportion of patients with TD do not have a timely diagnosis. Clinicians may not recognize early TD symptoms, as mild cases may be more easily missed. Due to TD movements, patients may stop taking their treatments for mood disorders or schizophrenia. Clinicians may inaccurately rate how bothersome side effects are to patients. New medications for TD are available, and evidence-based treatment recommendations have been published. Recent research has explored longer-term safety and efficacy with newer medications. Clinicians need up-to-date guidance on the prevalence of TD, risk factors for TD, recognition of early signs and symptoms of TD, and assessment tools that will help them diagnose and monitor TD. They also need education about discussing TD risk and signs with patients and family members and should be aware of the burden of TD for patients and families. Up-to-date, evidence-based, expert guidance should be provided on using new medications to treat TD in patients with mood disorders and schizophrenia, including longer-term use. This activity was designed to meet the needs of participants in CME activities provided by the CME Institute of Physicians Postgraduate Press, Inc., who have requested information on tardive dyskinesia.
Disclosure of Off-Label Usage
Dr Kremens has determined that, to the best of his knowledge, no investigational information about pharmaceutical agents that is outside US Food and Drug Administration–approved labeling has been presented in this activity.
The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer who is without conflict of interest.
This activity is derived from the teleconference series "Early Recognition and Treatment of Tardive Dyskinesia in Patients with Mood Disorders and Schizophrenia," which was held in April—July 2019 and supported by an educational grant from Neurocrine Biosciences, Inc. The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter.
Daniel E. Kremens, MD, JD
Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
The faculty for this CME activity and the CME Institute staff were asked to complete a statement regarding all relevant personal and financial relationships between themselves or their spouse/partner and any commercial interest. The Accreditation Council for Continuing Medical Education (ACCME) defines a commercial interest as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME defines relevant financial relationships as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. The CME Institute has resolved any conflicts of interest that were identified. No member of the CME Institute staff reported any relevant personal financial relationships. Faculty financial disclosure is as follows:
Dr Kremens is a consultant for Teva, UCB, Sunovion, Impax, Lundbeck, Acadia, USWorldMeds, Adamas, AbbVie, Merz, Allergan, Acorda, Kyowa, Neurocrine, GE Healthcare, and St Jude Medical; is a member of the speakers/advisory boards for Teva, UCB, Impax, Lundbeck, Acadia, USWorldMeds, and Adamas; and has received grant/research support from Acorda and Enterin. The Chair for this activity, Joseph P. McEvoy, MD, has received grant/research support from Takeda, Alkermes, Boehringer Ingelheim, Teva, Neurocrine, and Otsuka; has received honoraria from Neurocrine; and is a member of the speakers/advisory boards for Merck, Neurocrine, and Alkermes.
The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.
MOC APPROVAL STATEMENT
Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, Earlier Diagnosis of Tardive Dyskinesia has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:
MOC PART II CME ACTIVITY
Psychiatry and Neurology
- 0.50 AMA PRA Category 1 Credit™
- 0.50 Participation