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, introduces the first case.

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

"Case 1. Let's start with Paul. He's a 41-year-old white male. He's overweight. Has paranoid schizophrenia since age 25 and had also some alcohol abuse since age 27 with intermittent abstinence and alcohol abuse relapses. He's been living for the last 10 years in a residential home, is on social disability, and had, unfortunately, multiple psychiatric hospitalizations, some due to non-adherence, some, reportedly at least, due to breakthrough psychosis when he said he was taking the medication as prescribed.

He had been on multiple trials of antipsychotics including high doses of aripiprazole, risperidone, a combination of quetiapine that was augmented with haloperidol (Haldol Decanoate,Janssen Pharmaceuticals, Inc.) olanzapine plus haloperidol, and all with varying success. For the last five years, he has been stable regarding positive symptoms with some moderate negative symptoms while treated with paliperidone palmitate (Invega Sustenna, Janssen Pharmaceuticals, Inc.) once monthly injectable 150 milligrams per month.

He then was noticed to have developed orofacial dyskinesia about six months ago. It was noticed not so much by him but by the guidance counselor at the group home. Initially, the patient was reluctant to see a psychiatrist about this issue as he barely notices the movements himself and wants no change to his treatment. More recently, he was being stared at and made fun of by other residents in the group home which distressed Paul and makes him even less socially involved on top of his social withdrawal due to the negative symptoms."