Tardive Dyskinesia: Treatment Update
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Purpose of Review
Tardive dyskinesia (TD) is caused by exposure to medications with dopamine antagonism, mainly antipsychotics. It often distresses individuals, physically and emotionally and affects their quality of life. We evaluated peer-reviewed recently published articles with a goal of providing a critically appraised update on the latest advancements in this field.
In 2017, FDA approved VMAT2 inhibitors, deutetrabenazine and valbenazine. They have demonstrated efficacy in several class 1 studies. Also there have been update in the evidence-based guidelines for treatment for tardive dyskinesia.
Various medication classes are being used for treatment of TD with VMAT2 inhibitors to be first FDA-approved medications. Their use should be tailored to the individual patient. Long-term studies will further guide us in how to optimize treatment, especially in the real-world setting. As clinicians, we need to take into consideration all aspects of symptomatology, etiology, potential side effects of the medications, to find the best possible “match” for our patients.
KeywordsTardive dyskinesia Antipsychotics VMAT2 inhibitors Antioxidants Vitamins Neuroleptic-induced movements disorders
Compliance with Ethical Standards
Conflict of Interest
Divya Arya, Tarannum Khan, and Adam J. Margolius each declare no potential conflicts of interest. Hubert H. Fernandez has received research support from Acorda Therapeutics, Michael J. Fox Foundation, Movement Disorders Society, NIH/NINDS, Parkinson Study Group, Sunovion, but has no owner interest in any pharmaceutical company. Dr. Fernandez has received honoraria from American Osteopathic Association, Cleveland Clinic, South Alabama Medical Science Foundation Thoraxx Clinical Communications, UMA Education, as a speaker in CME events. Dr. Fernandez has received honoraria from Acorda Therapeutics, Denali Therapeutics, Pfizer, Partners Healthcare System(Parkinson Study Group), Sunovion Research and Development Trust as a consultant. Elsevier as the Editor-In-Chief of Parkinsonism and Related Disorders Journal. Dr. Fernandez has received royalty payments from Demos Publishing and Springer for serving as a book author/editor. The Cleveland Clinic has a contract with Teva for Dr. Fernandez’ role as a Co-Principal Investigator in SD-809/Austedo Tardive Dyskinesia global studies. Dr. Fernandez also serves as a member of the publication committee for Acorda Pharmaceuticals, Sunovion Pharmaceuticals but does not receive any personal compensation for this.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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