Fact or Fiction? Test Your Knowledge on Assessment and Management Strategies in Tardive Dyskinesia 1. What is your highest attained credential? * MD/DO PA/PA-C NP RN PharmD/RPh PhD LCSW Other, please specify: 2. What is your specialty? * Psychiatry Neurology Primary Care Research Other Other, please specify: 3. Which of the following is NOT a risk factor for tardive dyskinesia? * a. Exposure to ondansetron b. Older age c. Greater cumulative exposure to dopamine receptor–blocking agents d. Exposure to metoclopramide 4. Vesicular monoamine transporter type 2 (VMAT2) inhibitors control tardive dyskinesia symptoms by: * a. Increasing the amount of dopamine released by presynaptic neurons b. Decreasing the amount of dopamine released by presynaptic neurons c. Increasing the amount of serotonin released by presynaptic neurons d. Decreasing the amount of serotonin released by presynaptic neurons Your patient is a 35-year-old man who takes antipsychotics to control his bipolar disorder symptoms. His wife recently mentioned that he has started making unusual movements with his lips and tongue. 5. Which of the following would be most appropriate for assessing whether this patient has tardive dyskinesia? * a. Ask the patient to record the number of times he notices himself making involuntary movements between now and the next visit b. Informally observe the patient during the visit, looking for signs of involuntary movements c. Administer the Abnormal Involuntary Movement Scale (AIMS) d. Reduce the dose of the patient’s antipsychotic and ask him at the next visit whether the movements have stopped or lessened Your patient is a 31-year-old man taking a second-generation antipsychotic to control his bipolar disorder symptoms. He has no characteristics that put him at high risk for developing extrapyramidal symptoms. 6. While the patient remains on the antipsychotic, how often should he be assessed for tardive dyskinesia? * a. Assessment is unnecessary unless he reports experiencing symptoms of tardive dyskinesia b. Every 3 months c. Every 6 months d. Annually Your patient is a 64-year-old woman who was diagnosed with schizophrenia at age 33 and has been taking antipsychotics ever since. Her caregiver mentions that the patient has been making unusual movements with her face and body for some time, and recently the movements have gotten more frequent. The patient is unaware of the movements, but your assessment indicates that she is experiencing tardive dyskinesia. 7. Which of the following would be the most appropriate approach for managing this patient’s tardive dyskinesia? * a. Discontinue the antipsychotic until her involuntary movements stop b. Employ a watch-and-wait approach; at present this patient is untroubled by her symptoms of tardive dyskinesia c. Initiate treatment with a VMAT2 inhibitor d. Initiate treatment with benztropine
