The Weekly Mind Reader: How Tardive Dyskinesia Hinders Treatment

Tardive dyskinesia (TD) was once considered a rare syndrome but clinicians now understand that it’s actually a common side effect of long-term exposure to antipsychotics. And as clinicians also know, it can take a heavy toll on the well-being of their patients.

This week, a study in The Journal of Clinical Psychiatry took a much needed look at the substantial burden TD places on a patient’s overall functioning. To better understand the challenges of this involuntary movement disorder, a team led by Texas Tech University School of Medicine researchers surveyed 269 TD patients. All of the subjects had an initial diagnosis of either schizophrenia, bipolar disorder (BD), or major depressive disorder (MDD) and developed TD after taking medication.

Among their findings:

• More than 85 percent of patients treated for schizophrenia developed TD, compared to 72 and 69 percent of patients with BD or MDD, respectively. 

 

• Over 90 percent of patients rated TD’s impact on their physical abilities as moderate-to-severe. Symptoms left them struggling with everything from exercise to household chores to eating and speaking. 

 

• Three-quarters of patients said TD made them feel sad, anxious, and unmotivated, and also made it hard to socialize. Half worried about negative reactions to their uncontrolled movements.

 

• Doing schoolwork was not easy for the majority of students with TD. And nearly 70 percent of patients in the workforce admitted that managing TD had a significant effect on their career by reducing productivity and presenteeism.

 

• A third of patients stopped or cut back on their antipsychotic medication after a TD diagnosis, even though the uncontrolled movements are permanent in the majority of cases. A good portion of them turned to other drugs like muscle relaxants or sleeping pills to help mitigate their symptoms.

This is one of the most thorough studies of the TD disease state ever conducted. The researchers stressed how important it is to take patients’ concerns seriously. Addressing the bothersome nature of TD quickly and with compassion could go a long way toward reducing treatment disruptions and nonadherence for the underlying condition.

In other interesting neurology and psychiatry news this week:

• Primary care should adapt to the needs of people with serious mental illness for better cardiometabolic outcomes. 

 

• A new study helped quantify the incidence of neuropsychiatric events in people living with HIV–1 who take antivirals.

 

• Here’s an interesting case report of dissociative amnesia with fugue in a middle-aged man who experienced multiple psychosocial stressors.

 

• Last week, a shooter opened fire at the Covenant School in Nashville, killing three 9-year-olds and three adults. We spoke to a Nashville-based pediatrician who warned that gun violence has left an entire generation of children feeling unsettled and unsafe.

 

• Here’s your Tweet of the Week, because the only thing better than a dad joke, is a medical dad joke. 

Did you hear about the guy whose whole left side was cut off?  He's all right now.#meded #nursetwitter #foamed #nurse #medtwitter #jokes #dadjokes #humor #funny #MondayMood

— Medical Dad Jokes (@MedicalDadJokes) April 3, 2023