Improving Outcomes in TD

CE / CME

Case Challenge: Irregular, Uncontrolled Movements Impairing Social Life

Physician Assistants/Physician Associates: 0.75 AAPA Category 1 CME credit

Social Workers: 0.75 ASWB ACE CE Credit

Pharmacists: 0.75 contact hour (0.075 CEUs)

Psychologists: 0.75 APA CE Credit

Nurses: 0.75 Nursing contact hour, including 0.75 hour of pharmacotherapy credit 

Physicians: Maximum of 0.75 AMA PRA Category 1 Credit

Released: December 08, 2022

Expiration: December 07, 2023

Jeremy A. Schreiber
Jeremy A. Schreiber, MSN, APRN, PMHNP-BC

Activity

Progress
1
Course Completed
Which of the following adverse events has been seen at higher doses of VMAT2 inhibitors?
Both FDA-approved VMAT2 inhibitors have a reduced dose requirement when used with medications that strongly inhibit metabolism along which pathway?

Utilization of which of the following medication classes is associated with the greatest prevalence of tardive dyskinesia?

References

  1. Cloud LJ, Zutshi D, Factor SA. Tardive dyskinesia: therapeutic options for an increasingly common disorder. Neurotherapeutics. 2014;11:166-176.
  2. Cornett EM, Novitch M, Kaye AD, et al. Medication-induced tardive dyskinesia: a review and update. Ochsner J. 2017;17:162-174.
  3. Waln O, Jankovic J. An update on tardive dyskinesia: from phenomenology to treatment. Tremor Other Hyperkinet Mov (N Y). 2013;3:tre-03-161-4138-1.
  4. Anderson KE, Stamler D, Davis MD, et al. Deutetrabenazine for treatment of involuntary movements in patients with tardive dyskinesia (AIM-TD): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Psychiatry. 2017;4:595-604.
  5. Fernandez HH, Factor SA, Hauser RA, et al. Randomized controlled trial of deutetrabenazine for tardive dyskinesia: The ARM-TD study. Neurology. 2017;88:2003-2010.
  6. Robert. Tardive dyskinesia facts and figures. www.psychiatrictimes.com/view/tardive-dyskinesia-facts-and-figures. Accessed November 11, 2022.
  7. Davis MC, Miller BJ, Kalsi JK, et al. Efficient trial design—FDA approval of valbenazine for tardive dyskinesia. N Engl J Med. 2017;376:2503-2506.
  8. Brasic J, Benbadis S. Tardive dyskinesia. emedicine.medscape.com/article/1151826-print. Accessed November 11, 2022.
  9. Carbon M, Hsieh CH, Kane JM, et al. Tardive dyskinesia prevalence in the period of second-generation antipsychotic use: a meta-analysis. J Clin Psychiatry, 2017;78:e264-e278.
  10. Loughlin AM, Lin N, Abler V, et al. Tardive dyskinesia among patients using antipsychotic medications in customary clinical care in the United States. PLoS ONE. 2019;14:e0216044.
  11. Hauser RA, Factor SA, Marder SR, et al. KINECT 3: a phase 3 randomized, double-blind, placebo-controlled trial of valbenazine for tardive dyskinesia. Am J Psychiatry. 2017;174:476-484.
  12. Caroff SN, Yeomans K, Lenderking WR, et al. RE-KINECT: a prospective study of the presence and healthcare burden of tardive dyskinesia in clinical practice settings. J Clin Psychopharmacol. 2020;40:259-268.
  13. Bhidayasiri R, Jitkritsadakul O, Friedman JH, et al. Updating the recommendations for treatment of tardive syndromes: a systematic review of new evidence and practical treatment algorithm. J Neurol Sci. 2018;389:67-75.
  14. Guy W. ECDEU Assessment Manual for Psychopharmacology: Revised (DHEW publication number ADM 76-338). Rockville, MD, US Department of Health, Education and Welfare, Public Health Service, Alcohol, Drug Abuse and Mental Health Administration, NIMH Psychopharmacology Research Branch, Division of Extramural Research Programs, 1976: 534-537.
  15. Keepers GA, Fochtmann LJ, Anzia JM, et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. Am J Psychiatry. 2020;177:868-872..
  16. Factor S. Management of tardive syndrome: medications and surgical treatments. Neurotherapeutics. 2020;17:1694-1712.
  17. American Academy of Neurology. Treating and managing tardive syndromes. www.aan.com/Guidelines/Home/GetGuidelineContent/614. Accessed November 11, 2022.
  18. Deutetrabenazine prescribing information. Parsippany, NJ: Teva; 2022.
  19. Valbenazine prescribing information. San Diego, CA: Neurocine; 2022.
  20. Stahl SM. Mechanism of action of vesicular monoamine transporter 2 (VMAT2) inhibitors in tardive dyskinesia: reducing dopamine leads to less "go" and more "stop" from the motor striatum for robust therapeutic effects. CNS Spectr. 2018;23:1-6.
  21. Powell A, et al. Parkinsonism in the psychiatric setting: an update on clinical differentiation and management. BMJ Neurology Open 2020;2:e000034.
  22. Hauser RA, Barkay H, Fernandez HH, et al. Long-term deutetrabenazine treatment for tardive dyskinesia is associated with sustained benefits and safety: a 3-year, open-label extension study. Front Neurol. 2022;13:773999.