Current perspectives on the epidemiology and burden of tardive dyskinesia: a focused review of the clinical situation in Japan

Abstract

Tardive dyskinesia (TD) is a movement disorder that can develop with the use of dopamine receptor-blocking agents and is most commonly caused by antipsychotics. The use of antipsychotics is expanding, which may lead to an increased number of patients experiencing TD. To summarise the current knowledge of the epidemiology and risk factors for TD in Japan, we reviewed articles related to the current state of knowledge around TD identified through a PubMed search, and held a roundtable discussion of experts in Japan on 9 September 2021 to form the basis of the opinion presented within this review. The true prevalence of TD among patients treated with antipsychotics is not well characterised; it is reported to be between 15% and 50% globally and between 6.5% and 7.7% in Japan. Potential barriers to timely treatment of TD include the stigma surrounding mental health issues and the lack of data regarding TD in Asian patients. This review summarises the current knowledge of the epidemiology, challenges to TD diagnosis and risk factors for TD in Japan. Recent strategies for symptom monitoring and early diagnosis, as well as consensus recommendations are included. Achieving a high level of awareness of TD among physicians who treat patients with psychiatric disorders is of great importance and physicians should ensure that patients with psychiatric disorders receiving antipsychotics are proactively monitored for signs of TD. Plain Language Summary Plain Language Summary ( In Japanese ) Visual Summary Visual Summary ( In Japanese )

Impact of tardive dyskinesia on patients and caregivers: a survey of caregivers in the United States

“…Caregivers play an important role in monitoring TD symptoms and treatment of TD. Caregivers are more likely to notice subtle symptoms and are in a position to monitor for potentially life-threatening complications of TD, such as dyspnea and dysphagia [ 19 ]. It is therefore important for clinicians to recognize and assess caregiver burden.…”

Tardive dyskinesia in Asia— current clinical practice and the role of neurologists in the care pathway

“…While DRBAs, including APDs, are known to be causative agents in the development of TD and are an inherent part of its definition, they can also be considered as risk factors depending on how they are used (e.g., dose, frequency, and duration). Modifiable risk factors include the use of APDs and some other therapeutic drugs, and the presence of certain comorbid conditions, such as diabetes mellitus, that can be controlled with suitable therapeutic management ( 68 , 71 ). Similarly, smoking as well as alcohol and substance abuse, are also known to increase TD risk, but have the potential to be modified with lifestyle changes.…”

“…As previously discussed, the association between APD use and the development of TD is well-known in the global literature and is an example of a potentially modifiable risk factor. Such modifications often include the use of SGAs in preference to FGAs, and reducing the dose and duration of exposure to APDs wherever possible ( 68 , 71 ). However, it should be noted that data supporting the suggestion that SGA are less likely to cause TD than FGA are subject to debate, and while the general consensus from experts is that SGA are safer, not all data support this contention.…”