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Tardive Dyskinesia Care in Special Populations

CE

Management of Tardive Dyskinesia With Considerations for Special Populations: Helping Our Patients Age Well

Nurses: 1.00 Nursing contact hour

Released: September 20, 2024

Expiration: September 19, 2025

Amber Hoberg
Amber Hoberg, PMHNP-BC
Martha Sajatovic
Martha Sajatovic, MD
CME/CE Information

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
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1.

Of the following risk factors for developing TD, which is of particular relevance in older patients?

2.

When assessing a patient’s movement, which symptom would indicate a diagnosis OTHER THAN TD? 

3.

Which statement is true as supported by published data on VMAT2 inhibitors specific to older adults with TD?

4.

Patient Case


Marlene is a 72-yr-old woman treated for several decades with a combination of second-generation antipsychotic medication (quetiapine 200 mg/day) and lithium (600 mg/day) for type 1 bipolar disorder


Comorbidity: type 2 diabetes and hypertension. Problem alcohol use in the remote past but has maintained sobriety for nearly 2 decades


For the past 3 yr, Marlene has been functioning well and is able to run her own private landscaping business


Approximately 2 yr ago, Marlene developed some involuntary perioral movements and movements of her hands that her HCP diagnosed as TD. Her HCP attempted to taper and stop her quetiapine, but Marlene became hypomanic (insomnia, mildly pressured speech, irritability) when the quetiapine dosage was reduced below 150 mg/day. The HCP has subsequently maintained her on a combination of lithium (serum level
0.8 mEq/L) and quetiapine 150 mg/day


Two wk ago, Marlene had a fall while working with landscaping equipment. Fortunately, she was not injured. Marlene tells her HCP that her hands are “twitching and shaking” and she feels these involuntary hand movements are interfering in her ability to manage her job

The next best course of action for Marlene’s HCP is:

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