This protocol applies to patients with an approved indication for ongoing antipsychotic use who have developed tardive dyskinesia that is at least moderate in severity and disrupts their activities of daily living and quality of life.
The patient continues antipsychotic therapy for an approved indication. Tardive dyskinesia is present and troublesome — at least moderate — at a level that meaningfully interferes with daily function and quality of life. This functional threshold is the criterion for initiating suppressive management.
The protocol involves adding an adjuvant agent to help suppress residual symptoms. The complete selection criteria, sequencing, and monitoring parameters are detailed in the full regimen — only a structured review reveals the appropriate choice for this patient.
DOI: 10.1016/j.jns.2018.02.010
In patients with troublesome TS, suppressive agents should be considered.
Suppressive therapy should be considered when disabilities are at least moderate and interfere with ADLs and QoL, with new VMAT2 inhibitors or TBZ (if both Deut-TBZ and valbenazine are not available) as the first-line treatment, with clonazepam and Ginkgo biloba as second-line, and combined with amantadine if symptoms are still troublesome.
In patients whose symptoms are still not adequately controlled, TBZ or amantadine may be considered as an adjuvant.
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