TD Management

Understanding TD Impact

The impact of tardive dyskinesia (TD) goes far beyond involuntary movements^1,2

75% of patients reported that TD severely impacted them socially, physically, and psychologically³

IMPACT-TD Scale: A tool developed and published by a consensus panel of experts to help guide the routine monitoring and evaluation of TD impact.

Download the IMPACT-TD Scale to evaluate how
TD affects your patients’ lives

Ready to practice? Try online with patient videos
For more about the scale developed by the consensus
panel, download the full reprint

3-year longitudinal registry and study ongoing to assess the impact of TD and real-world treatment patterns and outcomes: learn more. The Phase 4, multicenter, prospective, observational 2-part study is the largest-ever of its kind for TD and will collect information from both patients and physicians.

In a survey of 269 patients, the impact of TD on daily living was substantial—even for patients with self-assessed mild/moderate symptoms⁴

Psychological/psychiatric factors³

Effect on underlying condition
Compliance with treatment
Development of other psychiatric symptoms (eg, anxiety)
Other negative emotions

Social factors^2,5

Effect on relationships
Social isolation
Withdrawal

Physical factors^2,6,7

Speech impairment
Difficulty eating
Reduced fine motor function
Impaired gait/balance

Vocational factors⁸

Inability or reduced ability to perform job duties
Challenges with employment
Avoidance of people

See a real patient’s story: the daily impact of TD

TD symptoms can disrupt the treatment of your patient’s underlying condition^4,8

In the same survey, patients with TD reported that their involuntary movements interfered with adherence to psychiatric treatment⁴:

48.4%

Skipped doses of antipsychotic medication or took less than doctor instructed

39.3%

Stopped taking antipsychotic medication altogether

35.7%

Stopped going to the doctor to treat their underlying condition

20.8%

Advised someone else not to take an antipsychotic medication

Patient characteristics in the TD Impact Study

LEARN MORE: EVALUATING TD IMPACT

No clinical trials have been conducted to demonstrate that treating TD affects the outcomes on this page.

Watch Amber Hoberg, PMHNP-BC, discuss the importance of assessing and managing TD

For more videos, visit the YouTube page.

REFERENCES: 1. Cloud LJ, Zutshi D, Factor SA. Tardive dyskinesia: therapeutic options for an increasingly common disorder. Neurotherapeutics. 2014;11(1):166-176. 2. Yassa R. Functional impairment in tardive dyskinesia: medical and psychosocial dimensions. Acta Psychiatr Scand. 1989;80(1):64-67. 3. Data on file. Parsippany, NJ: Teva Neuroscience, Inc. 4. Jain R, Ayyagari R, King S, Edwards GG, Wilhelm A, Leo S. Impact of tardive dyskinesia on physical, psychological, and social aspects of patient lives: a survey of patients and caregivers in the United States. Presented at: Psych Congress 2021; October 29–November 1, 2021; San Antonio, TX. 5. Ascher-Svanum H, Zhu B, Faries D, Peng X, Kinon BJ, Tohen M. Tardive dyskinesia and the 3-year course of schizophrenia: results from a large, prospective, naturalistic study. J Clin Psychiatry. 2008;69(10):1580-1588. 6. Strassnig M, Rosenfeld A, Harvey PD. Tardive dyskinesia: motor system impairments, cognition and everyday functioning. CNS Spectr. 2018;23(6):370-377. 7. Waln O, Jankovic J. An update on tardive dyskinesia: from phenomenology to treatment. Tremor Other Hyperkinet Mov (N Y). 2013;3:tre-03-161-4138-1. doi:10.7916/D88P5Z71 8. Jackson R, Brams MN, Citrome L, et al. Assessment of the impact of tardive dyskinesia in clinical practice: consensus panel recommendations. Neuropsychiatr Dis Treat. 2021;17:1589-1597.

Important safety information

Depression and Suicidality in Patients with Huntington’s Disease: AUSTEDO XR and AUSTEDO can increase the risk of depression and suicidal thoughts and behavior (suicidality) in patients with Huntington’s disease. Balance the risks of depression and suicidality with the clinical need for treatment of chorea. Closely monitor patients for the emergence or worsening of depression, suicidality, or unusual changes in behavior. Inform patients, their caregivers, and families of the risk of depression and suicidality and instruct them to report behaviors of concern promptly to the treating physician. Exercise caution when treating patients with a history of depression or prior suicide attempts or ideation. AUSTEDO XR and AUSTEDO are contraindicated in patients who are suicidal, and in patients with untreated or inadequately treated depression.

Contraindications: AUSTEDO XR and AUSTEDO are contraindicated in patients with Huntington’s disease who are suicidal, or have untreated or inadequately treated depression. AUSTEDO XR and AUSTEDO are also contraindicated in: patients with hepatic impairment; patients taking reserpine or within 20 days of discontinuing reserpine; patients taking monoamine oxidase inhibitors (MAOIs), or within 14 days of discontinuing MAOI therapy; and patients taking tetrabenazine or valbenazine.

Clinical Worsening and Adverse Events in Patients with Huntington’s Disease: AUSTEDO XR and AUSTEDO may cause a worsening in mood, cognition, rigidity, and functional capacity. Prescribers should periodically re-evaluate the need for AUSTEDO XR or AUSTEDO in their patients by assessing the effect on chorea and possible adverse effects.

QTc Prolongation: AUSTEDO XR and AUSTEDO may prolong the QT interval, but the degree of QT prolongation is not clinically significant when AUSTEDO XR or AUSTEDO is administered within the recommended dosage range. AUSTEDO XR and AUSTEDO should be avoided in patients with congenital long QT syndrome and in patients with a history of cardiac arrhythmias.

Neuroleptic Malignant Syndrome (NMS), a potentially fatal symptom complex reported in association with drugs that reduce dopaminergic transmission, has been observed in patients receiving tetrabenazine. The risk may be increased by concomitant use of dopamine antagonists or antipsychotics. The management of NMS should include immediate discontinuation of AUSTEDO XR and AUSTEDO; intensive symptomatic treatment and medical monitoring; and treatment of any concomitant serious medical problems.

Akathisia, Agitation, and Restlessness: AUSTEDO XR and AUSTEDO may increase the risk of akathisia, agitation, and restlessness. The risk of akathisia may be increased by concomitant use of dopamine antagonists or antipsychotics. If a patient develops akathisia, the AUSTEDO XR or AUSTEDO dose should be reduced; some patients may require discontinuation of therapy.

Parkinsonism: AUSTEDO XR and AUSTEDO may cause parkinsonism in patients with Huntington’s disease or tardive dyskinesia. Parkinsonism has also been observed with other VMAT2 inhibitors. The risk of parkinsonism may be increased by concomitant use of dopamine antagonists or antipsychotics. If a patient develops parkinsonism, the AUSTEDO XR or AUSTEDO dose should be reduced; some patients may require discontinuation of therapy.

Sedation and Somnolence: Sedation is a common dose-limiting adverse reaction of AUSTEDO XR and AUSTEDO. Patients should not perform activities requiring mental alertness, such as operating a motor vehicle or hazardous machinery, until they are on a maintenance dose of AUSTEDO XR or AUSTEDO and know how the drug affects them. Concomitant use of alcohol or other sedating drugs may have additive effects and worsen sedation and somnolence.

Hyperprolactinemia: Tetrabenazine elevates serum prolactin concentrations in humans. If there is a clinical suspicion of symptomatic hyperprolactinemia, appropriate laboratory testing should be done and consideration should be given to discontinuation of AUSTEDO XR and AUSTEDO.

Binding to Melanin-Containing Tissues: Deutetrabenazine or its metabolites bind to melanin-containing tissues and could accumulate in these tissues over time. Prescribers should be aware of the possibility of long-term ophthalmologic effects.

Common Adverse Reactions: The most common adverse reactions for AUSTEDO (>8% and greater than placebo) in a controlled clinical study in patients with Huntington’s disease were somnolence, diarrhea, dry mouth, and fatigue. The most common adverse reactions for AUSTEDO (4% and greater than placebo) in controlled clinical studies in patients with tardive dyskinesia were nasopharyngitis and insomnia. Adverse reactions with AUSTEDO XR extended-release tablets are expected to be similar to AUSTEDO tablets.

Please see full Prescribing Information, including Boxed Warning.

The impact of tardive dyskinesia (TD) goes far beyond involuntary movements1,2

In a survey of 269 patients, the impact of TD on daily living was substantial—even for patients with self-assessed mild/moderate symptoms4

TD symptoms can disrupt the treatment of your patient’s underlying condition4,8

In the same survey, patients with TD reported that their involuntary movements interfered with adherence to psychiatric treatment4:

Watch Amber Hoberg, PMHNP-BC, discuss the importance of assessing and managing TD

The impact of tardive dyskinesia (TD) goes far beyond involuntary movements^1,2

In a survey of 269 patients, the impact of TD on daily living was substantial—even for patients with self-assessed mild/moderate symptoms⁴

TD symptoms can disrupt the treatment of your patient’s underlying condition^4,8

In the same survey, patients with TD reported that their involuntary movements interfered with adherence to psychiatric treatment⁴: