Tardive Dyskinesia Clinical Case Review

Christoph U. Correll, MD, professor of psychiatry at The Zucker School of Medicine at Hofstra/Northwell and professor and chair of the department of child and adolescent psychiatry at Charité University Medicine in Berlin, Germany, discusses the first case.

Editor’s note: The following is an automatically generated transcript of the above video.

"Let's discuss case one. In this case, Paul with schizophrenia who developed tardive dyskinesia after multiple exposures to antipsychotics. And his risk factors included his middle age, schizophrenia as a diagnosis, because schizophrenia also can lead to dyskinetic movements independent of dopamine blockade, his comorbid alcohol abuse, the intermittent antipsychotic treatment and non-adherence, as well as exposure to high dose and first-generation antipsychotics.

Since all the risk factors were either unmodifiable or had already been addressed, and since the patient required his longstanding treatment with an antipsychotic, in this case a short treatment with paliperidone palmitate, augmentation with one of the two-FDA approved treatments, VMAT-2 inhibitors for tardive dyskinesia, valbenazine or deutetrabenazine, were the most evidence-based treatment options. And valbenazine, in this case, was chosen for dosing and titration simplicity.

Paul did respond well without relevant adverse effects, some transient mild sedation he got used to, and his TD symptoms fell below the diagnostic threshold of TD. He had only one mild, and you need two mild symptoms in two areas or one moderate in at least one body area. He had only mild residual movements and felt much less psychologically distressed, less stigmatized externally, and that resolved also secondary negative symptoms of active social withdrawal."