psychiatrist

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Educational Activity

What You Should Know About Tardive Dyskinesia: Screening, Causes, and New Treatment Options

J. Sloan Manning, MD, and Joseph P. McEvoy, MD

Published: February 21, 2018

Abstract

Tardive dyskinesia (TD) is a serious condition that affects patients’ ability to control movements. Clinicians who treat patients with either first- (FGA) or second-generation antipsychotics (SGAs) should regularly screen their patients for potential TD symptoms. While SGAs pose less risk than FGAs for developing these symptoms, the risk is not zero. Additionally, other risk factors have been identified to help clinicians identify which patients may have a higher chance of developing these movements. Clinicians have access to numerous screening tools, such as the Abnormal Involuntary Movement Scale (AIMS), that can help identify these difficult-to-detect movements. Footage of an actual patient during a real-time AIMS exam is presented inside this activity. Currently, two medications have been approved by the US Food and Drug Administration for the treatment of TD. During this webcast presentation, listen actively as our faculty discuss both these new treatment options and several older options.

This CME activity is expired. For more CME activities, visit CMEInstitute.com.
Find more articles on this and other psychiatry and CNS topics:
The Journal of Clinical Psychiatry
The Primary Care Companion for CNS Disorders

Do you know which of your patients are at risk for developing tardive dyskinesia? Watch this Webcast to learn about how to prevent tardive dyskinesia in your patients and new treatment strategies for your patients who have already been diagnosed.

J. Sloan Manning, MD
Department of Family Medicine, University of North Carolina, Chapel Hill, and the Mood Disorders Clinic, Cone Family Practice Center, Greensboro, North Carolina
Joseph P. McEvoy, MD
Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University


This CME activity is expired. For more CME activities, visit cme.psychiatrist.com.
Find more articles on this and other psychiatry and CNS topics:
The Journal of Clinical Psychiatry
The Primary Care Companion for CNS Disorders

CME Background Information

Supported by an educational grant from Neurocrine Continental, Inc., a wholly-owned subsidiary of Neurocrine Biosciences, Inc.

Participants may receive credit by reading the activity, correctly answering the posttest questions, and completing the evaluation.

Objective

After completing this educational activity, you should be able to:

  • Routinely use screening tools to identify early signs of tardive dyskinesia in patients who are prescribed medications associated with its risk
  • Employ current evidence-based strategies to manage tardive dyskinesia

Financial Disclosure

The faculty for this CME activity and the CME Institute staff were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. No member of the CME Institute staff reported any relevant personal financial relationships. Faculty financial disclosures are as follows:

Dr Manning is a consultant for Otsuka, Sunovion, Takeda, Lundbeck, and Alkermes and is a member of the speakers/advisory boards for Otsuka, Sunovion, Takeda, and Lundbeck.

Dr McEvoy is a consultant for Neurocrine and Teva and has received grant/research support from Alkermes, Avanir, Boehringer Ingelheim, and Otsuka.

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release, Review, and Expiration Dates

This program was published in November 2017 and is eligible for AMA PRA Category 1 Credits through November 31, 2019. The latest review of this material was October 2017.

Statement of Need and Purpose

Some physicians are unaware that tardive dyskinesia (TD) is associated with second-generation antipsychotic (SGA) agents to a greater extent than previously thought. Education about the prevalence and incidence of TD and risk factors and screening tools is needed because SGAs are used to treat multiple illnesses and the older first-generation antipsychotic agents are also still prescribed. Early recognition is key to management of TD, but subtle signs are easily missed if routine standardized screening is not performed. Survey data show that many psychiatrists have not received training on TD, most do not feel competent in using a screening scale, and most do not discuss TD risk with patients before prescribing antipsychotics. Some clinicians continue treatment unchanged after a movement disorder has appeared because patients are responding so positively to the present treatment regimen. Not only does this increase the chances for TD symptoms to become permanent, it can lead to patient nonadherence, which may ultimately lead to relapse. Therefore, education for physicians is also needed about evidence-based treatment options for patients with TD. This activity was designed to meet the needs of participants in CME activities provided by the CME Institute of Physicians Postgraduate Press, Inc., who have requested information on TD.

Disclosure of Off-Label Usage

Drs Manning and McEvoy have determined that, to the best of their knowledge, valbenazine and deutetrabenazine are the only drugs approved by the US Food and Drug Administration for the treatment of tardive dyskinesia.

Review Process

The entire faculty of the series discussed the content at a peer-review planning session, the Chair reviewed the activity for accuracy and fair balance, and a member of the External CME Advisory Board reviewed the activity to determine whether the material is evidence-based and objective.

Acknowledgment

This Webcast activity is derived from the planning teleconference series “What You Should Know About Tardive Dyskinesia: Screening, Causes, and New Treatment Options,” which was held in May and August 2017 and supported by an educational grant from Neurocrine Biosciences, Inc. The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter.


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