A 69 year old male has an extensive medical history including schizophrenia, depression, Parkinson’s disorder, and hypertension. He has historically been fairly adherent to his medication regimen, but recently decided that he did not want to take his aripiprazole (Abilify). He had been tried on various antipsychotics for years.
Within weeks of stopping his aripiprazole 10 mg daily, he began experiencing troublesome movements in his lips and tongue as well as abnormal shoulder and trunk movements. This is a classic example of tardive dyskinesia. The newer antipsychotics have less risk of causing TD, but still can.
With this patient, he did not want to restart the aripiprazole as he felt that he no longer needed it, so the team decided to try to adjust his Parkinson’s medication to help best alleviate the symptoms.
I’ve definitely seen this scenario a few times and generally tardive dyskinesia will show up when the dose of a long term antipsychotic is reduced. It is especially more likely when the dose reduction or discontinuation is more aggressive (i.e. going from a high dose to nothing very quickly). TD is also more likely with some of the older antipsychotic agents (typicals) like haloperidol etc. Reference
Pharmacy Times has listed this blog #1 in a recent article! You get my 30 medication mistakes PDF for FREE! Over 3,000 have subscribed to the blog. Why haven’t you?