A Biopsychosocial Approach to Improving Quality of Life in Tardive Dystonia

Abstract

Tardive dystonia is a potential side effect of antipsychotic medications and certain other dopamine antagonists. It is characterized by sustained muscle contractions that lead to abnormal postures and movements. It is generally a permanent side effect that has a significant impact on a patient's physical, psychological, and social well-being, decreasing overall quality of life. The authors present the case of a patient with severe tardive dystonia due to metoclopramide that illustrates the profound physical, psychological, and social impact of this condition. It is important for clinicians to be knowledgeable about tardive dystonia so that they can take active steps to prevent its development and have a positive impact on its prognosis when it does develop by recognizing the condition early. Treatment of tardive dystonia should follow a biopsychosocial approach that combines an array of treatment modalities, depending on the individual presentation. Incorporating a quality of life questionnaire specific to dystonia into clinical practice can help clinicians tailor care to the needs of the individual patient.

Tardive Dystonia due to D2 Antagonists and Other Agents

“…Furthermore, work productivity, finding an employment, and coping with family roles become compromised. Quality of life accordingly deteriorates, to a greater extent in patients with generalized dystonia than in those with focal [60], and is associated with anxiety and depression [61].…”

Treatment of Tardive Dystonia Induced by Antipsychotics, Old and New

“…3 Tardive dystonia is associated with increased psychiatric morbidity, mortality, and severely decreased quality of life. [7][8][9] Even though second-generation antipsychotics (SGAs) have been associated with lower incidence rates of movement disorder, compared with first-generation antipsychotics (FGAs), the risk still exists, contrary to expectations. 1,[10][11][12][13][14] Absolute numbers of drug-induced movement disorders are further increased because of the currently widespread use of antipsychotics for indications other than psychosis, such as mood disorders.…”