How would you treat a patient with tardive dyskinesia (TD)?
Patients with psychiatric disorders can present with involuntary, uncontrolled movements that are collectively called tardive dyskinesia (TD). The involuntary movements are repetitive, persistent, and can be observed in the face, the jaw, tongue and lips, as well as in the extremities or trunk. Facial movements include tongue protrusion, grimacing, and lip smacking. It can be embarrassing, socially isolating, and can often add to the stigma related to their mental illness.
Tardive Dyskinesia is not a symptom of the underlying disease, but rather a side effect of their drug treatment, typically associated with antipsychotic therapies that inhibit dopamine receptors. Patients with schizophrenia or bipolar disorder are commonly affected by TD, as well as patients prescribed antipsychotics over a prolonged period for other conditions such as major depressive disorder. Between 20–30% of patients receiving long-term antipsychotics are thought to develop TD.
If a patient presented with TD and her psychiatric disorder was well-controlled, how would you treat that patient’s TD? What is your rationale for that treatment plan?