Screening for Tardive Dyskinesia Associated with Antipsychotic Treatment

DENVER — Screening for the presence of tardive dyskinesia should be considered in patients receiving treatment with antipsychotic agents, as the repetitive movements associated with the disorder may have a negative impact on quality of life, according to research presented at the American Association of Nurse Practitioners (AANP) 2018 National Conference.

Rose Mary Xavier PhD, MS, RN, PMHNP-BC, from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues participated in the prospective cohort RE-KINECT study (ClinicalTrials.gov Identifier: NCT03062033). A total of 236 patients with ≥3 months of exposure to antipsychotic medication were included and assigned to 1 of 2 cohorts:  those without visual involuntary movements associated with tardive dyskinesia (72%; Cohort 1) and those with possible tardive dyskinesia as confirmed by clinician assessment (28%; Cohort 2).

Mean exposure to antipsychotics in Cohort 2 was 15.1 years; 60% of the participants in this cohort were women, with a mean age of 56.6 years. Patients were most commonly diagnosed with bipolar disorder (49%), major depressive disorder (34%), and schizophrenia (22%). Anxiety disorder was identified as the most frequently reported comorbidity (54%).

The researchers examined 4 body regions for involuntary movement associated with possible tardive dyskinesia: head (facial muscles); arms, hands, or fingers; legs, feet, or toes; and trunk. Assessment of involuntary movements was communicated as “none,” “some,” or “a lot.”

Approximately 51% of patients in Cohort 2 experienced abnormal involuntary movements in at least 2 body regions. Movements were most frequently reported in the head (some, 42%; a lot, 24%), followed by the upper extremities (some, 39%; a lot, 16%) and the lower extremities (some, 30%; a lot, 8%).

“Abnormal movements were seen most often in the head and extremities, but all body areas should be evaluated for [tardive dyskinesia] in patients receiving antipsychotics,” the authors concluded.

For more information from AANP 2018, click here.

Reference

Xavier RM, Caroff S, Gilbert N, et al. RE-KINECT: a prospective real-world tardive dyskinesia screening study and registry in patients taking antipsychotic agents. Presented at the American Association of Nurse Practitioners 2018 National Conference. June 26-29, 2018; Denver, CO. Industry Scientific Poster 13.