Section - Quick Takes

03. Tardive Syndromes: Clinical Manifestations and Treatment Strategies

Published on August 1, 2023 Certification expiration date: August 1, 2026

Gregory Pontone, M.D., M.H.S.

Division Chief of Aging, Behavioral, and Cognitive Neurology - University of Florida College of Medicine

Key Points

Dr. Gregory Pontone discusses a review that discusses the clinical manifestations, possible mechanisms, and treatment options for tardive syndromes. The use of second-generation VMAT2 inhibitors as the evidence-based, first-line therapy is emphasized.

To unlock this audio you need to become a Silver, Gold, Silver extended or Gold extended Member.

Check Our CME Program

Downloads for Offline Access

Download Audio File (MP3)

Text version

Hello. This is Greg Pontone for the Psychopharmacology Institute. Today, I’m covering the article “Tardive Syndrome Is a Mysterious Phenomenon with Different Clinical Manifestations,” a review by Badarny et al. The current article reviews the assessment and best evidence treatment for tardive syndromes.

Tardive syndromes are most commonly seen in patients undergoing treatment with antipsychotics that block dopamine type 2 receptors. DSM-5 defines tardive syndromes as a dopamine receptor blocking agent-induced movement disorder that persists despite discontinuation or change in medication dosage. Symptoms must persist for a month or more after discontinuing medication to confirm tardive syndrome diagnosis.

There are 2 components of tardive syndromes—first, abnormal or involuntary movements or sensory symptoms associated with dopamine receptor blocking agent exposure, and second, the persistence or worsening of symptoms after the offending drug is withdrawn. The mechanism for tardive syndromes is unclear; however, it is hypothesized that dopamine receptor upregulation and hypersensitivity

Unlock this Quick Take and earn 0.50 CMEs
Become a Silver, Gold, Silver extended or Gold extended Member.

Get Instant Access

Already have an account? Sign in

Next Section

04. Effect of Pharmacogenomics Testing on Clinical Outcomes in Major Depressive Disorder

Learning Objectives:

Assess the efficacy and safety of brexanolone for the treatment of postpartum depression while considering the administration requirements, potential side effects, and cost of the medication.
Discuss the potential effects of aripiprazole on prolactin levels and metabolic parameters in patients with schizophrenia and type 2 diabetes.
Identify the clinical manifestations of tardive syndromes and apply evidence-based treatment approaches in managing patients with tardive syndromes.
Evaluate the findings of a meta-analysis on pharmacogenomic testing in the outcomes among patients with major depression.
Discuss the potential benefits and considerations of using GCSF, like filgrastim, in a clozapine rechallenge for patients who experienced agranulocytosis or neutropenia.

Original Release Date: August 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: August 1, 2026

Expert: Scott Beach, M.D., Paul Zarkowski, M.D., Vivien Burt, M.D. Oliver Freudenreich, M.D., Gregory Pontone, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

Greg Pontone declares the following interest:

- Acadia Pharmaceuticals Inc: consultant

Oliver Freudenreich declares the following interests:

- Alkermes: Research grant to institution, consultant honoraria

- Janssen: Research grant to institution, consultant honoraria

- Otsuka: Research grant to institution

- Karuna: Research grant to institution, consultant honoraria

- Neurocrine: Consultant honoraria

- Vida: Consultant honoraria

- American Psychiatric Association: Consultant honoraria

- Medscape: Honoraria

- Elsevier: Honoraria

- Wolters-Kluwer: Royalties

- UpToDate: Royalties, honoraria

All of the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

None of the other faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.