Medication Options and Clinical Strategies for Treating Tardive Dyskinesia

Finally, you can offer patients with tardive dyskinesia approved medications that reduce symptoms. In this CME, Dr Leslie Citrome reviews the evidence.

Abstract

Valbenazine and deutetrabenazine are FDA-approved as treatment for tardive dyskinesia (TD). Both medications are vesicular monoamine transporter type 2 (VMAT2) inhibitors, and both are effective for reducing TD symptoms. Clinicians need to be aware of the adverse effects of valbenazine and deutetrabenazine, as well as other key differences between the two, in order to individualize treatment. Using the Abnormal Involuntary Movement Scale assists clinicians in assessing progress for each patient. Treating TD effectively with these new medications will reduce the burden of the condition for patients.

From the Series: Revisiting Tardive Dyskinesia: Focusing on the Basics of Identification and Treatment

To cite: Citrome L. Medication options and clinical strategies for treating tardive dyskinesia. J Clin Psychiatry. 2020;81(2):TV18059BR2C.

To share: https://doi.org/10.4088/JCP.TV18059BR2C

© Copyright 2020 Physicians Postgraduate Press, Inc

Target Audience

Psychiatrists, neurologists, nurse practitioners, and physician assistants

Learning Objectives

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

  • Review TD treatment options to select the most appropriate agent for each patient
  • Provide proactive strategies to address functional impairments associated with TD
Activity summary
Available credit: 
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 Participation
Activity opens: 
01/23/2020
Activity expires: 
01/31/2022
Cost:
$0.00
Rating: 
0

Support Statement

Supported by an educational grant from Teva Pharmaceuticals.

Learning Objectives

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

  • Review TD treatment options to select the most appropriate agent for each patient
  • Provide proactive strategies to address functional impairments associated with TD

Release, Review, and Expiration Dates

This brief report activity was published in January 2020 and is eligible for AMA PRA Category 1 Credit™ through January 31, 2022. The latest review of this material was November 2019.

Statement of Need and Purpose

Many clinicians are unable to identify risk factors for TD, are unfamiliar with diagnostic criteria, and do not regularly assess patients for TD. New medications for TD are available, evidence-based treatment recommendations have been published, and research has explored longer-term safety and efficacy with new medications. But clinicians may be slow to implement treatment strategies due to underestimation of the social and occupational impact that TD has on patients’ lives and uncertainty about what to do due to lack of training. Education is therefore needed on the risk factors that should alert clinicians to monitor certain patients especially closely for TD and strategies to assess all patients being treated with dopamine-blocking agents and provide an accurate diagnosis. Clinicians also need awareness of the burden of TD and need up-to-date, evidence-based, expert guidance on using new medications in the treatment of TD, 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 Citrome has determined that, to the best of his knowledge, only valbenazine and deutetrabenazine are approved by the US Food and Drug Administration for the treatment of tardive dyskinesia (TD), and all other treatments discussed are off-label.

Review Process

The faculty member 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 a peer reviewer who is without conflict of interest.

Acknowledgment

This activity is derived from the teleconference series “Revisiting Tardive Dyskinesia: Focusing on the Basics of Identification and Treatment,” which was held in July and August 2019 and supported by an educational grant from Teva Pharmaceuticals. 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

Leslie L. Citrome, MD, MPH
Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla


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 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 Citrome is a consultant for Acadia, Alkermes, Allergan, Avanir, BioXcel, Eisai, Impel, Indivior, Intra-Cellular Therapies, Janssen, Lundbeck, Luye, Merck, Neurocrine, Noven, Osmotica, Otsuka, Pfizer, Sage, Shire, Sunovion, Takeda, Teva, Vanda; is a member of the speaker bureaus for Acadia, Alkermes, Allergan, Janssen, Lundbeck, Merck, Neurocrine, Otsuka, Pfizer, Sage, Shire, Sunovion, Takeda, Teva; and is a stock shareholder of Bristol-Myers Squibb, Eli Lilly, Johnson & Johnson, Merck, and Pfizer.

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 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 DirectoryMedication Options and Clinical Strategies for Treating 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

Available Credit

  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 Participation

Price

Cost:
$0.00
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