A Modified Delphi Consensus Study of the Screening, Diagnosis, and Treatment of Tardive Dyskinesia

Caroff, Stanley N.; Citrome, Leslie; Meyer, Jonathan M.; Sajatovic, Martha; Goldberg, Joseph F.; Jain, Rakesh; Lundt, Leslie; Lindenmayer, Jean Pierre; McEvoy, Joseph P.; McIntyre, Roger S.; Tohen, Mauricio; Ketter, Terence A.

doi:10.4088/jcp.19cs12983

Cited by 19 publications

(27 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, this strategy can result in insufficient control or relapse of the underlying psychiatric illness and may also cause withdrawal dyskinesias. 1 , 19 , 41 , 42 …”

Section: Resultsmentioning

confidence: 99%

“…However, this strategy can result in insufficient control or relapse of the underlying psychiatric illness and may also cause withdrawal dyskinesias. 1,19,41,42 Time Points for Assessing the Impact of TD Recommendation #4: Assessment of TD impact should be a routine aspect of the evaluation performed at every patient visit because TD impact varies over time and can influence treatment decisions.…”

Section: Underlying Psychiatric Disordersmentioning

confidence: 99%

“…When patients are treated for TD, assessment of changes in the degree of impact in response to treatment should be part of routine clinical evaluations. 1 In patients with untreated TD, routine monitoring should be performed to quickly identify any worsening of the condition or its impact, which may warrant the initiation of treatment for TD. 1,19,26 Approaches to Assessing the Impact of TD Recommendation #5: The key domains listed in Recommendation #3 should be utilized to assess TD impact.…”

Section: Underlying Psychiatric Disordersmentioning

confidence: 99%

“…1 In patients with untreated TD, routine monitoring should be performed to quickly identify any worsening of the condition or its impact, which may warrant the initiation of treatment for TD. 1,19,26 Approaches to Assessing the Impact of TD Recommendation #5: The key domains listed in Recommendation #3 should be utilized to assess TD impact. When assessing TD impact, clinicians should consult with the patient directly and/or with caregivers, family, and friends, especially when the individual has limited insight into their abnormal movements and their impact on function.…”

Section: Underlying Psychiatric Disordersmentioning

confidence: 99%

“…Tardive dyskinesia (TD) is a hyperkinetic movement disorder in which patients experience abnormal involuntary movements that occur most often in the orofacial region but can also occur in the neck, trunk, upper and lower extremities, and other muscles (eg, diaphragmatic and pharyngeal musculature). [1][2][3][4][5] TD can occur during or after stopping treatment with dopamine receptor antagonists or partial agonists, including typical (first-generation) and atypical (second-generation) antipsychotics, and some medications used to treat gastrointestinal disorders, such as metoclopramide. 3,[6][7][8] The lifetime prevalence of TD in patients treated with antipsychotics is estimated to be between approximately 15% and 40%, with higher rates reported in older (age >55 years) patients 9 ; higher rates are also observed among women who are postmenopausal.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Assessment of the Impact of Tardive Dyskinesia in Clinical Practice: Consensus Panel Recommendations

Jackson¹,

Brams²,

Citrome³

et al. 2021

NDT

Self Cite

View full text Add to dashboard Cite

Purpose: Tardive dyskinesia (TD) is a hyperkinetic movement disorder in which patients experience abnormal involuntary movements that can have profound negative impacts on physical, cognitive, and psychosocial functioning. Use of measures to assess the functional impact of TD in routine clinical practice is lacking. To address this gap, an advisory panel of experts in psychiatry and movement disorder neurology was convened to develop consensus recommendations on assessment of the impact of TD on patients' functioning that can be used in clinical practice. Methods: An advisory panel provided recommendations using an iterative process, beginning with a narrative literature review regarding current practices for assessing the impact of TD in clinical settings. A detailed summary was generated, and the advisory panel provided comments about the content and answered questions about assessing TD impact in clinical practice. The panelists' responses were discussed during a virtual meeting held on August 28, 2020. A second meeting on September 25, 2020, focused on developing and refining recommendations for assessment of the impact of TD in clinical practice. At the conclusion of the second meeting, general consensus was reached on all recommendation statements. Results: As part of routine clinical practice, it is imperative to assess the impact of TD on the patient's life to help guide treatment decisions. Key domains for assessing the overall impact of TD include social, physical, vocational, and psychological functioning and the impact of TD on the underlying psychiatric disorder. Assessment of TD impact should be performed at every patient visit. Impact assessments should include consultation with patients, caregivers, and family members. Shared decision-making to initiate TD treatment should consider impact. Conclusion:The impact of TD should be assessed routinely, including the key domains of social, physical, vocational, and psychological functioning and the impact of TD on the underlying psychiatric disorder.

show abstract

“…However, this strategy can result in insufficient control or relapse of the underlying psychiatric illness and may also cause withdrawal dyskinesias. 1 , 19 , 41 , 42 …”

Section: Resultsmentioning

confidence: 99%

Section: Underlying Psychiatric Disordersmentioning

confidence: 99%

Section: Underlying Psychiatric Disordersmentioning

confidence: 99%

Section: Underlying Psychiatric Disordersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Assessment of the Impact of Tardive Dyskinesia in Clinical Practice: Consensus Panel Recommendations

Jackson¹,

Brams²,

Citrome³

et al. 2021

NDT

Self Cite

View full text Add to dashboard Cite

show abstract

An Evidence-Based Update on Anticholinergic Use for Drug-Induced Movement Disorders

Vanegas-Arroyave,

Caroff,

Citrome

et al. 2024

CNS Drugs

Self Cite

View full text Add to dashboard Cite

Drug-induced movement disorders (DIMDs) are associated with use of dopamine receptor blocking agents (DRBAs), including antipsychotics. The most common forms are drug-induced parkinsonism (DIP), dystonia, akathisia, and tardive dyskinesia (TD). Although rare, neuroleptic malignant syndrome (NMS) is a potentially life-threatening consequence of DRBA exposure. Recommendations for anticholinergic use in patients with DIMDs were developed on the basis of a roundtable discussion with healthcare professionals with extensive expertise in DIMD management, along with a comprehensive literature review. The roundtable agreed that “extrapyramidal symptoms” is a non-specific term that encompasses a range of abnormal movements. As such, it contributes to a misconception that all DIMDs can be treated in the same way, potentially leading to the misuse and overprescribing of anticholinergics. DIMDs are neurobiologically and clinically distinct, with different treatment paradigms and varying levels of evidence for anticholinergic use. Whereas evidence indicates anticholinergics can be effective for DIP and dystonia, they are not recommended for TD, akathisia, or NMS; nor are they supported for preventing DIMDs except in individuals at high risk for acute dystonia. Anticholinergics may induce serious peripheral adverse effects (e.g., urinary retention) and central effects (e.g., impaired cognition), all of which can be highly concerning especially in older adults. Appropriate use of anticholinergics therefore requires careful consideration of the evidence for efficacy (e.g., supportive for DIP but not TD) and the risks for serious adverse events. If used, anticholinergic medications should be prescribed at the lowest effective dose and for limited periods of time. When discontinued, they should be tapered gradually. Graphical Abstract

show abstract

CO-aVoID: coronavirus outbreak affecting variability of presentations to a local emergency department

et al. 2021

View full text Add to dashboard Cite

A Modified Delphi Consensus Study of the Screening, Diagnosis, and Treatment of Tardive Dyskinesia

Cited by 19 publications

References 0 publications

Assessment of the Impact of Tardive Dyskinesia in Clinical Practice: Consensus Panel Recommendations

Assessment of the Impact of Tardive Dyskinesia in Clinical Practice: Consensus Panel Recommendations

An Evidence-Based Update on Anticholinergic Use for Drug-Induced Movement Disorders

CO-aVoID: coronavirus outbreak affecting variability of presentations to a local emergency department

Contact Info

Product

Resources

About