Tardive Dyskinesia Refresher: Causes, Identification, and Impact

Amber Hoberg, MSN, APRN, PMHNP-BC, provides a quick refresher on tardive dyskinesia for clinicians treating the disorder. Reinvigorate your clinical toolbox with information on the disorder's impact on patients and the essential requirements for successful treatment.

For more insights on the disorder, visit the Tardive Dyskinesia Excellence Forum.

Read the transcript:

Hi, I'm Amber Hoberg. I am a psychiatric mental health nurse practitioner from San Antonio, Texas. I work for Morningstar Family Medicine and Baptist Health System.

So, what is tardive dyskinesia? Well, tardive dyskinesia is an involuntary repetitive movement. Dopamine receptor-blocking agents cause tardive dyskinesia. In psychiatry, that is going to be your antipsychotic medications: both first-generation and second-generation antipsychotics can cause this issue.

"Tardive" the name means "late-occurring."

For most patients, they're going to be on these antipsychotics for years to months before they develop this movement disorder. Now, if you take care of patients over the age of 65, they don't take quite as long to develop tardive dyskinesia. Sometimes as little as a month of being subjected to antipsychotics before they develop this movement disorder.

This disorder is often permanent; very few of them reverse. Once patients have this, it's something they're going to continue to have whether they're on antipsychotic medications or they're off antipsychotic medications; this disorder is going to continue to cause problems for the patients. The most common area where tardive dyskinesia affects is the facial region. That's why 4 of the 7 areas of focus on the face in the Abnormal Involuntary Movement Scale (AIMS). The face region is the most common area where patients develop tardive dyskinesia.

Just to put it in perspective, you can get TD in anything with a striated muscle, which you have everywhere except your eyeball and your heart, so you can pretty much get it just about anywhere. It can also affect upper extremities, lower extremities, the trunk, the neck, the shoulders, and TD can sometimes be so bad it can actually get into the respiratory tract and cause patients to have gasping, grunting sounds, or almost like they sound short of breath, even though they'll tell you I'm not short of breath, but it sounds like they have that shortness of breath to them. So in general, this is what TD looks like, what it is, and it's something that needs to be treated.

Amber Hoberg, MSN, APRN, PMHNP-BC, is a board-certified psychiatric mental health nurse practitioner from University of Texas Health Science Center San Antonio. She has been working for the past 12 years with the adult and geriatric populations, treating all types of psychiatric conditions. Her background, as a Psychiatric Advanced Practice Nurse, includes outpatient, inpatient, group home, and nursing home/ALF settings. She currently works for Baptist Health System and Morning Star Family Medicine PLLC treating the chronically mentally ill in both inpatient and outpatient settings.