Patients with tardive dyskinesia being treated with vesicular monoamine transporter 2 inhibitors may see improvement in well-being along with TD symptoms.
Patients with tardive dyskinesia (TD) who experience symptom relief after treatment with vesicular monoamine transporter 2 (VMAT2) inhibitors may experience improvements in the symptoms of an underlying psychiatric disorder as well as improvements in social and physical wellbeing, according to results published in Mental Health Clinician.
“Reduction in severity of TD motor symptoms represents one aspect of treatment-related changes, but additional measures of social and physical well-being help capture the broader extent of patient benefit,” Jonathan M. Meyer, MD, and colleagues wrote. “Published case reports note that VMAT2 inhibitors provide improvement not only in clinical disease severity, but also in social and physical well-being.”
However, data on the impact of VMAT2 inhibitors on social and physical well-being in prospective clinical trials is limited, they noted.
For a study published in Mental Health Clinician, Dr. Meyer and colleagues examined clinician-reported improvement in TD symptoms as well as “noticeable changes” in social or physical well-being in patients with TD taking VMAT2 inhibitors.
Well-Being Improves in Conjunction With TD Symptoms
In total, 163 clinicians participated in the web-based survey. Participants reviewed the charts of 601 patients with TD (mean age, 50.6; 50% men) who were treated with VMAT2 inhibitors. Almost all patients (90%) had taken an antipsychotic in the previous 12 months, and most of those patients (77%) were still taking an antipsychotic at the time data was obtained.
Nearly half of these patients (47%) experienced TD symptoms in two or more body areas, most commonly the head or face and upper extremities. Further, before starting treatment, almost all patients (93%) experienced impairment in one or more social domains, and nearly the same percentage (88%) experienced impairment in one or more physical domains.
Following treatment, clinicians reported that most patients who experienced improvement in TD symptoms (n=540; 90%) also experienced improvements in well-being: 80% to 95% experienced improvement in social domains, and 90% to 95% showed improvement in physical domains. Many of these patients (73%) also experienced improvement of the primary psychiatric condition, according to the clinicians surveyed.
Using a “Holistic Approach” to Treat TD
In their conclusion, Dr. Meyer and colleagues addressed several limitations with the findings, including the use of a survey study design and its retrospective nature.
“While this survey was descriptive and retrospective in nature, the results are consistent with the data on functional improvement after TD treatment published in case studies,” they wrote.
Further, the findings underscore the importance of “a holistic approach” in treating TD that includes assessment of social and physical well-being for patients taking VMAT2 inhibitors, they continued.
“Regular assessment of TD impact on these types of domains should occur simultaneously with movement disorder ratings when evaluating the value of VMAT2 inhibitor therapy. Such assessments should include patient perspective on impact of TD and subsequent improvements after VMAT2 inhibitor treatment initiation to appreciate the true value of these therapies.”
