Understanding the New TD Treatment Guidelines

In this occasional feature, members of the Psych Congress Steering Committee and faculty answer questions asked by attendees at Psych Congress meetings.

At this year's Psych Congress Regionals meeting series, Psych Congress Steering Committee member Rakesh Jain, MD, MPH, is co-presenting on a session on the symptoms of tardive dyskinesia and clinical trial data and updates on treatments for the disorder.   

In this video, he answers the question: "What are the main points of the recent American Psychiatric Association guidelines on treating tardive dyskinesia?"

Read the transcript:

Thank you for asking the question about the recent guidelines on tardive dyskinesia from APA that just came out this year. There are a number of very important issues that emerge from these guidelines. 

The first is tardive dyskinesia is still significantly underdiagnosed. The guidelines strongly recommend that we improve our detection and identification of tardive dyskinesia. 

The second critical element of these guidelines is the need to take a biopsychosocial approach in appreciating our patients with tardive dyskinesia. We tend to focus on the biological aspects. Where are the movements? How severe are they? 

That's great, but the new guidelines really ask us to focus on the psychological, and social, and functional aspects of tardive dyskinesia too. They do recommend that if a patient has moderate or severe tardive dyskinesia, then we must treat it. In addition, they're recommending, if a patient has mild tardive dyskinesia, but there is the presence of impairment, then such patients should also be offered treatment. 

Finally, the other significant data emerging from these guidelines has to do with treatment options. We are being told to minimize the use of anticholinergics and to consider the use of the FDA-approved VMAT2 inhibitors, such as deutetrabenazine or valbenazine, to treat our patients. 

As you can see, these guidelines are new, and I do think they are incredibly helpful in guiding us to determine who has the disorder, who should we treat, should we take a biopsychosocial approach, and then finally, good advice on how to choose treatment options if a patient so decides it. I hope this answers your question.