The burden of tardive dyskinesia secondary to antipsychotic medication use among patients with mental disorders

McEvoy, Joseph P.; Park, Tyson; Schilling, Traci; Terasawa, Emi; Ayyagari, Rajeev; Carroll, Benjamin

doi:10.1080/03007995.2019.1569871

Cited by 5 publications

(14 citation statements)

References 17 publications

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“…Several other studies have also reported substantial increases in health care resource utilization and costs associated with the development of TD in the United States 17–19 . In a retrospective study of Truven MarketScan commercial and Medicare claims data, Carroll and Irwin 17 reported an increase in health care resource utilization in the 12 months after diagnosis of TD compared with the 12 months before a diagnosis of TD (inpatient admissions: 55.5% vs 40.0%, P < 0.001; ED visits: 61.5% vs 54.4%, P = 0.003).…”

Section: Discussionmentioning

confidence: 91%

“…Several other studies have also reported substantial increases in health care resource utilization and costs associated with the development of TD in the United States. [17][18][19] In a retrospective study of Truven MarketScan commercial and Medicare claims data, Carroll and Irwin 17 reported an increase in health care resource utilization in the 12 months after diagnosis of TD compared with the 12 months before a diagnosis of TD (inpatient admissions: 55.5% vs 40.0%, P < 0.001; ED visits: 61.5% vs 54.4%, P = 0.003). Rates of health care resource utilization and costs were also substantially higher in patients with TD after diagnosis compared with propensity score-matched patients without TD, with notable differences in inpatient admissions (55.5% vs 26.1%, P < 0.001) and ED visits (61.5% vs 40.6%, P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

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The Clinical and Economic Burden of Tardive Dyskinesia in Israel

Barer

Ribalov

Yaari

et al. 2022

J Clin Psychopharmacol

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Purpose/Background: Tardive dyskinesia (TD) is a hyperkinetic movement disorder caused by exposure to dopamine-receptor blockers. Data on TD burden in Israel are scarce. This analysis assesses the clinical and economic burden of TD in Israeli patients.Methods/Procedures: This retrospective analysis used a national health plan database (Maccabi Healthcare Services), representing 25% of the Israeli population. The study included adults alive at index date with an International Classification of Diseases, Ninth Revision, Clinical Modification TD diagnosis before 2018 and more than or equal to 1-year enrollment before diagnosis. Tardive dyskinesia patients were matched to non-TD patients (1:3) by underlying psychiatric condition, birth year, and sex. Treatment patterns and 2018 annual health care resource utilization and costs were assessed.Findings/Results: Of 454 TD patients alive between 2013 and 2018, 333 alive on January 1, 2018, were matched to 999 non-TD patients. At baseline, TD patients had lower socioeconomic status and higher proportion of chronic kidney disease and antipsychotic medication use; all analyses were adjusted accordingly. Tardive dyskinesia patients had significantly more visits to general physicians, neurologists, psychiatrists, physiotherapists, and emergency departments versus non-TD patients (all P < 0.05). Tardive dyskinesia patients also had significantly longer hospital stays than non-TD patients ( P = 0.003). Total healthcare and medication costs per patient were significantly higher in the TD versus non-TD population

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

The Clinical and Economic Burden of Tardive Dyskinesia in Israel

Barer

Ribalov

Yaari

et al. 2022

J Clin Psychopharmacol

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“…7,11 In addition to the TD symptoms themselves, older people may be more severely impacted by associated comorbidities and impaired physical and mental health. [13][14][15]78 Although the recent approval of VMAT2 inhibitors provides a new therapeutic option once TD occurs, avoiding this often irreversible movement disorder would be preferred. An important strategy for mitigating TD risk is prescribing APs that address psychiatric conditions while minimizing the risk of developing this disorder.…”

Section: Discussionmentioning

confidence: 99%

“… 7 , 11 In addition to the TD symptoms themselves, older people may be more severely impacted by associated comorbidities and impaired physical and mental health. 13–15 , 78 …”

Section: Discussionmentioning

confidence: 99%

Tardive Dyskinesia in Older Persons Taking Antipsychotics

Citrome¹,

Isaacson

Larson³

et al. 2021

NDT

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Tardive dyskinesia (TD) is a hyperkinetic movement disorder caused by the use of dopamine receptor-blocking agents (DRBAs), a category of medications that includes first-and second-generation antipsychotics (APs) and agents such as metoclopramide that are used for the treatment of nausea and gastrointestinal dysmotility. While TD can affect people of all ages, older age is associated with increased risk of TD and also with the emergence of TD occurring after shorter treatment durations and lower dosages of DRBAs. TD is characterized by involuntary movements that include the face, limbs, and trunk, and is associated with increased comorbidities, social stigmatization, and impaired physical and mental health. Once present, TD tends to persist despite AP dose adjustment or discontinuation. Even with the use of US Food and Drug Administration (FDA)-approved medications for TD, symptoms may persist. Because the leading hypothesis for the pathophysiology of TD has been dysregulation of dopamine transmission due to treatment with DRBAs, APs that avoid postsynaptic dopamine receptor blockade may provide an alternative therapeutic approach for patients who require an AP. In this review, we discuss the risks, burdens, prevention, and management of TD, with a focus on older people.

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“…The appearance of odd postures and movements may invite ridicule, bullying, and ostracism from observers and induce shame, withdrawal, and isolation in affected individuals. Several studies have shown correlations between TD and impaired cognition, poor response to treatment, greater risk of relapse, longer hospital stays, increased health care resource utilization, and lower quality of life and functioning [15,[17][18][19][20][21][22][23]. These correlations are often confounded by the concurrent effect of serious underlying psychiatric illnesses of the people in these studies.…”

Section: Introductionmentioning

confidence: 99%

An Experimental Study to Assess the Professional and Social Consequences of Tardive Dyskinesia

Ayyagari

Goldschmidt

et al. 2022

Clin Psychopharmacol Neurosci

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Objective: Antipsychotic medications may cause tardive dyskinesia (TD), an often-irreversible movement disorder characterized by involuntary movements that are typically stereotypic, choreiform, or dystonic and may impair quality of life. This study evaluated others' perceptions of abnormal TD movements in professional and social situations. Methods: This was an experimental, randomized, blinded, digital survey in a general population sample. Participants were randomized 1:1 into a test or control group to view a video of a professional actor simulating TD movements or no TD movements prior to completing surveys on employment, dating, and friendship domains. Assessments for mild-to-moderate and moderate-to-severe TD movements were conducted separately. Authenticity of abnormal movements and Abnormal Involuntary Movement Scale (AIMS) scores were evaluated by physician experts. Results: Surveys were completed by 2,400 participants each for mild-to-moderate and moderate-to-severe TD. In all domains, participants responded significantly less favorably to persons with TD movements (both mild-to-moderate and moderate-to-severe) than those without TD movements. Fewer participants in the test versus control group for mild-to-moderate and moderate-to-severe TD, respectively, considered the candidate as a potential employee (29.2% and 22.7% fewer), found him/her attractive (20.5% and 18.7% fewer), and were interested in becoming friends with him/her (12.3% and 16.5% fewer). Conclusion: Professional actors simulating TD movements were perceived more negatively than those without TD movements in employment, dating, and friendship domains. To our knowledge, this is the first randomized study to quantify professional and social stigma associated with TD movements that may reduce opportunities for gainful employment, marital status, and an effective support system.

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The burden of tardive dyskinesia secondary to antipsychotic medication use among patients with mental disorders

Cited by 5 publications

References 17 publications

The Clinical and Economic Burden of Tardive Dyskinesia in Israel

The Clinical and Economic Burden of Tardive Dyskinesia in Israel

Tardive Dyskinesia in Older Persons Taking Antipsychotics

An Experimental Study to Assess the Professional and Social Consequences of Tardive Dyskinesia

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