Antipsychotic-induced tardive dyskinesia: update on epidemiology and management

Curr Opin Psychiatry. 2019 May;32(3):179-184. doi: 10.1097/YCO.0000000000000491.

Abstract

Purpose of review: To provide an update on the frequency of antipsychotic-induced tardive dyskinesia and its management in patients with schizophrenia spectrum disorders in studies published since the last systematic review in 2008.

Recent findings: Recent data about antipsychotic-induced tardive dyskinesia in patients with schizophrenia underscore the superiority of newer generation antipsychotics (21%) over first-generation antipsychotics (30%) with respect to prevalence and incidence rates. Regarding recently tested management strategies, the new vesicular monoamine transporter 2 inhibitors valbenazine and deutetrabenazine have been found to be effective and may be considered as first-line pharmacotherapy for tardive dyskinesia. Owing to quality issues of randomized controlled trials and/or small sample sizes, limited and conflicting evidence remains for most treatment strategies.

Summary: The reviewed literature reveals lower prevalence rates of antipsychotic-induced tardive dyskinesia in patients treated with newer generation compared with first-generation antipsychotics. The evidence of vesicular monoamine transporter 2 inhibitors as a first-line therapy for tardive dyskinesia is well supported by several controlled clinical trials.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / classification
  • Antipsychotic Agents / therapeutic use
  • Humans
  • Medication Therapy Management*
  • Prevalence
  • Tardive Dyskinesia* / chemically induced
  • Tardive Dyskinesia* / epidemiology
  • Tardive Dyskinesia* / therapy

Substances

  • Antipsychotic Agents