How to Assess Tardive Dyskinesia Symptom Improvement With Measurement-Based Care

Measurement-based care has been found to be effective in patients with psychiatric conditions. Learn how to employ MBC for patients with tardive dyskinesia. 


Clinicians now have 2 effective and well-tolerated vesicular monoamine transporter 2 (VMAT2) inhibitors—valbenazine and deutetrabenazine—for the treatment of patients with tardive dyskinesia (TD), a severe and potentially irreversible side effect associated with dopamine receptor blocking agents. Clinicians should use measurement-based care, eg, the Abnormal Involuntary Movement Scale with activation maneuvers, to assess and document TD symptoms and treatment progress. Each follow-up visit should be personalized with questions related to patients’ functioning and level of distress regarding their specific TD symptoms. Family members, if available, can provide information on symptom changes and assistance with medication adherence. With continued treatment and measurement-based care, patients can experience improvement in their TD symptoms.

From the Series: JCP Fundamentals: Getting Back to the Basics—Diagnosing, Treating, and Educating Patients With Tardive Dyskinesia

To cite: McEvoy JP. How to assess TD symptom improvement with measurement-based care. J Clin Psychiatry. 2020;81(6):NU19047BR4C

To share:

© Copyright 2020 Physicians Postgraduate Press, Inc.

Target Audience

  • Psychiatrists
  • Neurologists
  • Nurse practitioners (NPs)
  • Physician assistants (PAs)

Learning Objectives

After completing this educational activity, you should be able to:

  • Provide measurement-based care for TD to adjust treatment as needed
Activity summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation
Activity opens: 
Activity expires: 

Support Statement

Supported by an educational grant from Neurocrine Biosciences, Inc.

Participants may receive credit by reading the activity, correctly answering the posttest question, and completing the evaluation.

Learning Objective

After completing this educational activity, you should be able to:

  • Provide measurement-based care for tardive dyskinesia (TD) to adjust treatment as needed

Release, Review, and Expiration Dates

This brief report activity was published in October 2020 and is eligible for AMA PRA Category 1 Credit™ through October 31, 2022. The latest review of this material was August 2020.

Statement of Need and Purpose

Clinicians may not recognize early TD symptoms, as mild cases may be more easily missed. A substantial proportion of patients with TD do not have a timely diagnosis, meaning that treatment is delayed and the chance for a poor outcome is increased. 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. Therefore, clinicians need education on the rates of TD with SGAs and FGAs; risk factors for the development of TD; how to use assessment tools that will help them diagnose and monitor TD; and discussing TD risk and signs with patients and caregivers. In addition, physicians need awareness of evidence-based, expert guidance on using approved medications in the treatment of TD, because effective medications for TD are available, and evidence-based treatment recommendations have been published. 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 TD.

Disclosure of Off-Label Usage

Dr McEvoy has determined that, to the best of his knowledge, no investigational information about pharmaceutical agents or device therapies that is outside US Food and Drug Administration–approved labeling has been presented in this activity.

Review Process

The faculty member agreed to provide a balanced and evidence-based presentation and discussed the topic and CME objective 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 “JCP Fundamentals: Getting Back to the Basics—Diagnosing, Treating, and Educating Patients With Tardive Dyskinesia,” which was held in March–September 2020 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.

Faculty Affiliation

Joseph P. McEvoy, MD
Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University

Financial Disclosure

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 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 McEvoy has received grant/research support from Biogen, Alkermes, Boehringer Ingelheim, Takeda, Auspex (Teva), and Lundbeck and is a member of the speaker/advisory boards for Intracellular and Sunovion.

Accreditation Statement

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.



Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 1.00 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.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation


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