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How is Tardive Dyskinesia Diagnosed?

What to expect when seeing a healthcare provider about this involuntary movement disorder.

Medically reviewed in January 2021

Tardive dyskinesia (TD) is an involuntary movement disorder that affects people who take neuroleptic medications. Neuroleptic medications are also known as antipsychotic medications.

These medications are primarily associated with the treatment of schizophrenia, a psychiatric disorder that causes a fragmented, distorted perception of reality. Antipsychotic medications are also prescribed for the treatment of the manic episodes of bipolar disorder, severe depression, and severe anxiety. They are also sometimes prescribed off-label—meaning they are prescribed for conditions other than they are indicated for.

If you or a loved one is taking antipsychotic medications, and/or experiencing symptoms of TD, the following is a look at how healthcare providers monitor, diagnose, and treat this condition.

Monitoring
If you or a loved one are taking an antipsychotic medication for any reason, your healthcare provider should be monitoring for both response to treatment as well as any adverse effects, including involuntary movement. Frequent monitoring is essential to the early diagnosis of TD. Early diagnosis and treatment are recommended, since TD symptoms can become permanent in many cases. In the early stages, discontinuing a medication or trying a lower dose of a medication may prevent TD symptoms from getting worse.

Diagnosis
TD is typically diagnosed with a physical exam and looking at a person’s medical history, especially the medications that they are taking and have taken in the past. Imaging tests may be ordered. These tests can help rule out other conditions that can cause involuntary movements. While TD symptoms are often recognizable as TD, involuntary movement disorders are not mutually exclusive. A healthcare provider may want to rule out other potential causes of involuntary movements, such as Parkinson’s disease, Huntington’s disease, or stroke.

Abnormal Involuntary Movement Scale
The Abnormal Involuntary Movement Scale (AIMS) is a diagnostic tool that healthcare providers use to diagnose TD. Administering AIMS takes roughly ten minutes. During that time, a healthcare provider will observe the patient for involuntary movements and also ask them questions about their symptoms. AIMS charts the parts of the body that are being affected by involuntary movements, as well as the severity of symptoms. It also charts the level of distress and incapacitation that a person is experiencing as a result of the symptoms.

Treatment
How TD is treated will vary from person to person, and treatment decisions will take into account a number of different factors about the patient, the medication they are taking, and the symptoms and severity of TD. If you or a loved one is experiencing symptoms of TD, the best thing you can do is work with your healthcare provider. Treatment may involve switching to a different antipsychotic medication, as well as medications and other therapies to control TD symptoms.

Sources:
National Organization for Rare Disorders. "Tardive Dyskinesia."
National Institute of Mental Health. "Schizophrenia."
Muhammad Atif Ameer and Abdolreza Saadabadi. "Neuroleptic Medications." StatPearls, 2020.
Elsevier Patient Education. "Tardive Dyskinesia."
Sarayu Vasan and Ranjit K. Padhy. "Tardive Dyskinesia." StatPearls, 2020.
John Muench and Ann M. Hamer. "Adverse effects of antipsychotic medications." American Family Physician, 2010. Vol. 81, No. 5.
John A. Gray. "Tardive Dyskinesia." Ferri's Clinical Advisor 2021.
National Institute of Mental Health. "Abnormal Involuntary Movement Scale (AIMS)."

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