Opinion
Video
The Role of VMAT2 Inhibitors in Tardive Dyskinesia
Panelists discuss how tardive dyskinesia in older adults often goes unrecognized due to symptom overlap with normal aging, underscoring the importance of early screening, timely intervention with evidence-based treatments like VMAT2 inhibitors, and a multidisciplinary approach to preserve function, independence, and mental well-being.
Older adults with undiagnosed or untreated tardive dyskinesia (TD) often experience a gradual worsening of symptoms that may be mistaken for normal aging. Subtle signs, such as abnormal gait, balance issues, or involuntary movements, can be overlooked or misattributed. This delay in recognition means many individuals are not diagnosed early, despite the fact that effective treatments are now available. The risk of developing TD increases with age and prolonged exposure to antipsychotic medications, particularly in those with serious mental illnesses who require long-term therapy.
As TD progresses without treatment, its impact on daily functioning becomes more pronounced. Individuals may have difficulty with basic activities such as eating, speaking, walking, or driving. Movements involving the face, mouth, and limbs can interfere with independence and reduce the ability to perform everyday tasks. These physical symptoms can also cause significant psychological distress, social withdrawal, and diminished quality of life, especially when people feel embarrassed or self-conscious in public settings. Early identification and management are key to preventing long-term disability and improving treatment response.
Providers should be especially vigilant in screening for TD in older adults, particularly those with a history of inconsistent medication adherence or co-occurring conditions like drug-induced parkinsonism. In some cases, patients may experience both TD and parkinsonian symptoms simultaneously, complicating diagnosis and treatment. When TD is properly recognized, evidence-based therapies—such as VMAT2 inhibitors—can significantly reduce symptoms. Addressing TD not only helps with physical movement but also supports mental well-being and restores patients’ ability to engage more fully in life.
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