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Tardive Dyskinesia

Luis L. Pérez, DO and Zachary Townsend, DO Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Tardive dyskinesia (TD) is a neurologic condition resulting in delayed and persistent, abnormal, involuntary stereotypic movements of the tongue, lips, face, trunk, and extremities (...

DIAGNOSIS

HISTORY

  • The diagnosis of TD is clinical, on exclusion of other etiologies. According to the DSM-5, TD consists of involuntary athetoid or choreiform movements generally of the tongue, lower f...

TREATMENT

MEDICATION

First Line

Cessation of neuroleptic or metoclopramide use (via taper) should be the initial option in patients who can tolerate such withdrawal. In some cases, short-term withdrawal...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Instruct patients and family members to be vigilant of early signs of any movement disorder.

  • Warn that TD may be exacerbated by stimulant use (Ri...

REFERENCES

1
Strassnig M, Rosenfeld A, Harvey PD. Tardive dyskinesia: motor system impairments, cognition and everyday functioning [published online ahead of print September 7, 2017]. CNS Spectr. doi:1...

ADDITIONAL READING

  • Atlas SJ, Agboola F, Curfman G. Effectiveness and value of 2 novel treatments for tardive dyskinesia. JAMA Intern Med.  2018;178(8):1110–1112. [View Abstract on OvidMedline]

  • Div...

CODES

ICD10

G24.01 Drug induced subacute dyskinesia 

ICD9

333.85 Subacute dyskinesia due to drugs 

SNOMED

  • 102449007 Tardive dyskinesia (disorder)

  • 38941006 Neuroleptic-induced tardive dyskinesia

CLINICAL PEARLS

  • 2nd-generation antipsychotics still have a risk for TD.

  • The older the patient and/or the longer the duration of antipsychotic use, the higher the risk of TD.

  • Use the minimum effective do...

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