Psychiatry

Tardive Dyskinesia

Expert Roundtables Podcast: The Differential Diagnosis of Drug-Induced Movement Disorders

expert roundtables by Leslie Citrome, MD, MPH; Joohi Jimenez-Shahed, MD; Adolfo Ramirez-Zamora, MD

Overview

<p>The differential diagnosis of drug-induced movement disorders can be challenging, as these disorders may present with similar symptoms, or multiple disorders may coexist in the same patient. While tardive dyskinesia can often be managed in psychiatric settings, a collaboration between psychiatrists and neurologists becomes important when symptoms are complex or to rule out conditions such as Parkinson’s disease. As noted by our experts in today’s podcast, caregivers can play a key role in recognizing abnormal movements.</p>

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. American Psychiatric Association; 2022.

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Chouksey A, Pandey S. Clinical spectrum of drug-induced movement disorders: a study of 97 patients. Tremor Other Hyperkinet Mov (N Y). 2020;10:48. doi:10.5334/tohm.554

Frei K, Truong DD, Fahn S, Jankovic J, Hauser RA. The nosology of tardive syndromes. J Neurol Sci. 2018;389:10-16. doi:10.1016/j.jns.2018.02.008

Hauser RA, Meyer JM, Factor SA, et al. Differentiating tardive dyskinesia: a video-based review of antipsychotic-induced movement disorders in clinical practice. CNS Spectr. 2022;27(2):208-217. doi:10.1017/S109285292000200X

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Kremens DE. Earlier diagnosis of tardive dyskinesia. J Clin Psychiatry. 2019;81(1):NU18041BR1C. doi:10.4088/JCP.NU18041BR1C

Loonen AJ, Ivanova SA. Neurobiological mechanisms associated with antipsychotic drug-induced dystonia. J Psychopharmacol. 2021;35(1):3-14. doi:10.1177/0269881120944156

Musco S, Ruekert L, Myers J, Anderson D, Welling M, Cunningham EA. Characteristics of patients experiencing extrapyramidal symptoms or other movement disorders related to dopamine receptor blocking agent therapy. J Clin Psychopharmacol. 2019;39(4):336-343. doi:10.1097/JCP.0000000000001061

Ward KM, Citrome L. Antipsychotic-related movement disorders: drug-induced parkinsonism vs. tardive dyskinesia—key differences in pathophysiology and clinical management. Neurol Ther. 2018;7(2):233-248. doi:10.1007/s40120-018-0105-0

Profile

Leslie Citrome, MD, MPH

Clinical Professor
Department of Psychiatry and Behavioral Sciences
New York Medical College
Valhalla, NY

Profile

Joohi Jimenez-Shahed, MD

Associate Professor of Neurology
Medical Director, Movement Disorders Neuromodulation and Brain Circuit Therapeutics
Icahn School of Medicine at Mount Sinai
New York, NY