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Understand the early characteristics of tardive dyskinesia, instead of ignoring them
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SAN DIEGO — Psychiatrists for too long have had a “desire to not be aware of the problem” of tardive dyskinesia, according a psychiatrist presenting at an industry press conference.
Most cases of tardive dyskinesia result from treatment with atypical antipsychotics, which are necessary for the treatment of major depressive disorder, bipolar disorder and schizophrenia.
“I cannot walk away from them [atypical antipsychotics], but they do have a curse,” said Rakesh Jain, MD, MPH, of the University of Texas Medical School. “It is a very problematic relationship that psychiatry has and the way we have dealt with it is by ignoring it.”
“The only way to dispel that is to give me hope,” he said.
One to two in 10 patients being treated with atypical antipsychotic will be affected by tardive dyskinesia and those patients comprise approximately 95% of all tardive dyskinesia cases, according to Jain. Tardive dyskinesia effects approximately 500,000 Americans.
“Tardive dyskinesia doesn’t arrive quick but it doesn’t leave,” he said.
Tardive dyskinesia manifests in the mouth, tongue, eye muscles and jaw. Patients may have extra blinking and the mouth may open and close — including lip smacking. It may also manifest in the toes and hands, Jain said.
“Those are late. You really need to focus around the face structure," he said.
There has been fourfold increase in tardive dyskinesia over the last 23 years as atypical antipsychotics are used more often, he said.
Jain said there is currently one approved treatment and another is coming.
He suggested other methods to reduce symptoms of tardive dyskinesia include sleep hygiene, stopping smoking, reducing alcohol intake, movement and mindfulness.
“To not use them guarantees millions will suffer and die so the best relationship I can have with a drug like that is with respect,” Jain said. – by Joan-Marie Stiglich
Reference:
Jain R. Talking about tardive dyskinesia. Presented at: Neurocrine Biosciences press conference; May 23, 2017; San Diego.
Disclosure: Jain has served as a consultant or an advisor of Neurocrine Biosciences.