➤ This pocket guide includes selected statements from the American
Psychiatric Association Practice Guideline for the Treatment of Patients
with Schizophrenia, 3rd edition related to the assessment and treatment of
tardive dyskinesia.
➤ Individuals with tardive dyskinesia, as with any individual with
schizophrenia, should be treated in the context of a person-centered
treatment plan that includes evidence-based non-pharmacological and
pharmacological treatments.
➤ Tardive syndromes can occur after exposure to any antipsychotic
medication. In adult patients treated with first-generation antipsychotic
agents, tardive dyskinesia occurs at a rate of approximately 4%-8% per
year, which is about three times the annual risk with second generation
antipsychotic agents.
➤ Various factors are associated with greater vulnerability to tardive
dyskinesia. Patients at increased risk for developing abnormal involuntary
movements include individuals older than 55 years; women; individuals
with a mood disorder, substance use disorder, intellectual disability, or
central nervous system injury; individuals with high cumulative exposure to
antipsychotic medications, particularly high potency dopamine D2 receptor
antagonists; and patients who experience acute dystonic reactions, clinically
significant parkinsonism, or akathisia. Abnormal involuntary movements can
also emerge or worsen with antipsychotic cessation.
➤ Please visit the full text guideline at for detailed recommendations
on the treatment of schizophrenia as well as detailed information on
pharmacology, side effects, and dosing information of antipsychotic
medications and VMAT2 inhibitors.
Introduction
