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Antipsychotic-induced tardive dyskinesia

update on epidemiology and management

Widschwendter, Christian G.; Hofer, Alex

Current Opinion in Psychiatry: May 2019 - Volume 32 - Issue 3 - p 179–184
doi: 10.1097/YCO.0000000000000491
SCHIZOPHRENIA AND RELATED DISORDERS: Edited by Lynn E. DeLisi and Iris E.C. Sommer
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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.

Department of Psychiatry, Psychotherapy, and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria

Correspondence to Christian G. Widschwendter, MD, Department of Psychiatry, Psychotherapy, and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Anichstr. 35, A-6020 Innsbruck, Austria. Tel: +43 512 504 23669; fax: +43 512 504 25267; e-mail: christian.widschwendter@tirol-kliniken.at

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