Case 3: Treatment Options
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, Germanye, discusses the treatment options for the third case.
Editor’s note: The following is an automatically generated transcript of the above video.
"So what are the risk factors for tardive dyskinesia in Mary? It's her older age, female sex, her depression diagnosis, mood disorders predisposed to the problem with tardive dyskinesia and obviously, the postsynaptic dopamine-related antipsychotic exposure. Since Mary received the atypical antipsychotic as augmentation for the insufficiently responding depression with an antidepressant, but since her depressant almost fully resolved, titrating down and then stopping the aripiprazole (Abilify, Bristol-Myers Squibb and Otsuka Pharmaceutical Co., Ltd) and keeping her on fluoxetine alone, maybe even stopping fluoxetine too are options one can consider.
Since the tardive movements are not more than mild yet, and early in development, addition of an antioxidant and radical scavenger, vitamin E is also an option that has been shown to be significantly better than placebo for tardive dyskinesia in meta-analyses, even though it is not FDA-approved for tardive dyskinesia. Addition of an FDA-approved VMAT-2 inhibitor such as valbenazine (Inbrace, Neurocrine Biosciences, Inc.) or deutetrabenazine (Austedo XR, Teva Neuroscience, Inc.) is also a possibility, but may not be necessary if the offending antipsychotic can be stopped, and that's not always the case if the TD symptoms that had relatively recent onset can potentially resolve over time when the antipsychotic is stopped."