Defining tardive dyskinesia

Tardive dyskinesia (TD) is a condition of involuntary movements of the face, trunk, and/or extremities that can vary in frequency and amplitude.1-3 TD results from treatment with dopamine receptor blocking agents (DRBAs), used for both psychiatric and nonpsychiatric conditions, and can persist even after discontinuing DRBA treatment.1,4

Test your knowledge

Know the signs of tardive dyskinesia

TD can occur in patients who are taking or have taken DRBAs.1,4

  • The signs of TD have distinct characteristics1-3
    • ‐ Athetoid and/or choreiform
    • ‐ Variable frequency and amplitude
  • Involuntary movements are often seen in the face, trunk, and extremities1,2,5
    • ‐ Lips
    • ‐ Jaw
    • ‐ Eyes
    • ‐ Tongue
    • ‐ Trunk
    • ‐ Arms
    • ‐ Legs
    • ‐ Hands
    • ‐ Feet
  • Video example of lip smacking, puckering, or pursing associated with tardive dyskinesia (TD).

    LIP SMACKING, PUCKERING, OR PURSING5

  • Video example of jaw distension, chewing, or grimacing associated with tardive dyskinesia (TD).

    JAW DISTENSION, CHEWING, OR GRIMACING5

  • Video example of tongue movement or protrusion associated with tardive dyskinesia (TD).

    TONGUE MOVEMENT OR PROTRUSION5

  • Video example of trunk and limb movements associated with tardive dyskinesia (TD).

    TRUNK AND LIMB MOVEMENTS5

  • Signs of TD can develop in as early as a few months after starting DRBA treatment and, for some patients, continue indefinitely, even after stopping or switching DRBA treatment.1
I have isolated myself from a lot of people, because it's really hard to pay attention to a conversation when people are just paying attention to your lip movement or your eye movement. Patient

How do you see TD?

Assessing TD can be challenging, and a patient’s condition can vary in severity over time.2

  • TD can fluctuate in frequency and amplitude3
  • Many patients often do not bring up or discuss the signs of TD6
  • Onset of TD may be variable, and signs may wax and wane over time1,7

TD can be assessed by reviewing the individual involuntary movements of the face, trunk, and extremities using the Abnormal Involuntary Movement Scale (AIMS).3,5

Face? Frequency? Amplitude? Trunk? Extremities? Assess for tardive dyskinesia (TD).

Take on TD: Do you know the signs?

1

Watch the video and assess the involuntary TD movements.

2

Rate the movements on a scale from 0 (none) to 4 (severe), then see how your assessment compares to that of a movement disorder neurologist.

LIP SMACKING, PUCKERING, OR PURSING5

NONE

MINIMAL

MILD

MODERATE

SEVERE


  • 0
  • 1
  • 2
  • 34
This is an educational tool to help provide physicians a visual representation of TD and to compare their assessment to that of a movement disorder neurologist. Assessments are not definitive. It's important to look for TD. Sign up for a resource about the different signs.

Next: Impact of TD

TD can be disruptive for some patients.2

Learn about the impact
References: 1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013:712. 2. Task Force on Tardive Dyskinesia. Tardive Dyskinesia: A Task Force Report of the American Psychiatric Association. American Psychiatric Association; Washington, DC; 1992. 3. Lane RD, Glazer WM, Hansen TE, et al. Assessment of tardive dyskinesia using the Abnormal Involuntary Movement Scale. J Nerv Ment Dis. 1985;173(6):353-357. 4. Kenney C, Hunter C, Davidson A, et al. Metoclopramide, an increasingly recognized cause of tardive dyskinesia. J Clin Pharmacol. 2008;48(3):379-384. 5. Guy W. ECDEU Assessment Manual for Psychopharmacology. Revised 1976. Rockville, MD: National Institute of Mental Health; 1976. 6. Macpherson R, Collis R. Tardive dyskinesia: patients' lack of awareness of movement disorder. Br J Psychiatry. 1992;160:110-112. 7. Schooler N, Kane J. Research and diagnoses for tardive dyskinesia. Arch Gen Psychiatry. 1982;39(4):486-487.

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