When tardive dyskinesia occurs in a patient with no primary psychotic disorder and no currently approved indication for antipsychotic therapy, the clinical calculus differs fundamentally — the agent driving the movement disorder cannot be justified on psychiatric grounds.
This protocol is specific to patients who do not have a primary psychotic disorder and for whom there is no approved indication for dopamine receptor blocking treatment. In this cohort the rationale for continuing the implicated agent is absent, making the management approach distinct from cases where ongoing antipsychotic coverage is required.
Management centres on addressing the offending agent directly.
DOI: 10.1016/j.jns.2018.02.010
For the cohort of patients who do not have a primary psychotic disorder or approved indications, discontinuing the offending drug seems to be the most logical choice, although long-term data show low rates of remission, and withdrawal dyskinesia may occur.
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