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Epidemiology, Prevention, and Assessment of Tardive Dyskinesia and Advances in Treatment

J Clin Psychiatry 2017;78(8):1136–1147
10.4088/JCP.tv17016ah4c
​​Diagnosing and Treating Patients With Mixed Features

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Tardive dyskinesia (TD) is a disorder characterized by involuntary movements, typically of the orofacial muscles and also of the extremities and other muscle groups. The condition is associated with exposure to dopamine receptor blocking agents, including antipsychotics. Because the indications and off-label uses for these agents have expanded over the last 2 decades, a larger number of patients are receiving antipsychotic medications than in the past. While evidence suggests that patients being treated with second-generation antipsychotics have less risk for developing TD than those treated with first-generation antipsychotics, the decreased risk is not as great as was originally expected. In addition, patients with chronic psychiatric conditions often require long-term use of antipsychotics, putting them at risk for TD. This article addresses the prevalence, risk factors, and prevention of TD; assessment strategies including diagnostic criteria and rating scales; and evidence for TD treatments, including 2 newly approved medications: deutetrabenazine and valbenazine.

From the Department of Psyc​hiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset; and Recognition and Prevention (RAP) Program, Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, New York (Dr Correll); Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset; and Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, New York (Dr Kane); and the Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla (Dr Citrome).

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