Tardive Dyskinesia in Geriatric Psychiatry

CE / CME

Transforming Care in Tardive Dyskinesia: ​Expert Guidance for Geriatric Psychiatry Practice

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

Nurse Practitioners/Nurses: 0.75 Nursing contact hour

Pharmacists: 0.75 contact hour (0.075 CEUs)

Physicians: maximum of 0.75 AMA PRA Category 1 Credit

Released: April 01, 2025

Expiration: March 31, 2026

Pretest

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

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

2.

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

3.

  • 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: