Because of COVID-19, many meetings and events have been moved online – but that does not mean the learning has stopped. During the virtual Psych Congress Elevate conference, which took place from July 25 – 27, Dr. Rakesh Jain, MD, MPH discussed the importance of proactively assessing patients for tardive dyskinesia (TD). According to the Psychiatry and Behavioral Health Learning Network, these assessments are particularly important for patients receiving antipsychotic medication.
Tardive Dyskinesia
As many people know, some medications can cause mild to severe adverse reactions. Drugs used to treat gastrointestinal or psychiatric conditions are no different. However, these dopamine-blocking drugs (neuroleptics, anticholinergics) can lead to the development of tardive dyskinesia (TD). Generally, this disorder causes involuntary movements, particularly of the lips, mouth, tongue, or face. People with schizophrenia have a heightened risk of developing tardive dyskinesia.
Symptoms include:
- Tongue thrusting
- Repetitive chewing
- Lip smacking
- Restlessness
- Rapid blinking
- Grimacing
- Changes in gait
- Piano-playing finger movements
- Difficulty swallowing or speaking
Read more about tardive dyskinesia here.
PCE Conference
During the conference, Dr. Jain noted that the impact of tardive dyskinesia often spans far beyond movement issues. In fact, the effects often involve financial, social, interpersonal, professional, and emotional struggles. To highlight this point, Dr. Jain supplemented his presentation with video clips in which patients with tardive dyskinesia discussed life’s complexities. Said one woman, whose husband has the disorder:
“People have stopped talking to us, and we lost a lot of friends. It’s taken hard work and therapy for both of us to be OK.”
With medication usage rising, we may also see an associated rise in TD and other related disorders. As a result, doctors should continue monitoring and assessing patients, even with the difficulty of COVID-19. One way this can be done, even while teleconferencing, is through the Abnormal Involuntary Movement Scale (AIMS). Using this assessment, doctors analyze whether the patient is moving their face, lips, tongue, jaw, or other parts of the body abnormally. Additionally, doctors ask patients questions about teeth comfort or any self-reported symptoms.
To make AIMS easier, Dr. Jain also explains that family members can be present during the assessment. This helps with additional reporting, as well as support. Overall, COVID-19 is getting in the way of optimal treatment. However, even some treatment and assessment is better than none.
