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 case.

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

"So Ida had multiple risk factors for the development of TD. She had bipolar disorder diagnosis, past dopamine-blocker-related motor side effects that were acute, like akathisia and Parkinsonism, had ongoing anticholinergic use and past use, and also hyperglycemia. The Biperiden could be stopped without any problems in terms of resurgence of any EPS, and that was done to reduce the risk of persistent TD. She also engaged in some healthy lifestyle adjustment that was possible and improved cardiometabolic risk factors.

However, the symptoms of the TD were still moderate in severity, and impairing and distressing. Therefore, the addition of the FDA-approved VMAT-2 inhibitor, deutetrabenazine, was initiated because we wanted more fine-grained titration possibility and that was well tolerated and led to significant and functionally-relevant improvement of TD symptoms that fell again, below the level of having tardive dyskinesia. There were two ones, which is minimal or borderline symptoms, and you need two twos, two mild symptoms for TD or one moderate, and again, she came from a nine-point rating to a two-point rating.

The ratings themselves are not only relevant, it's also location, location, location, as we can see in Ida's case. Basically, since it was in the face, people were seeing her movements, and also it interfered with the typing because she needed to use her hands and fingers, she was particularly distressed by the TD. And particularly, also then relieved when, in this case, to deutetrabenazine helped her with her tardive dyskinesia movements."