This Month in Psychopharmacology

Tardive Dyskinesia Awareness Week

Every year, we recognize the first full week of May as Tardive Dyskinesia Awareness Week (TDAW), to help increase awareness and education about tardive dyskinesia. This includes awareness to health care providers around the importance of regular screening for tardive dyskinesia, and effectively treating this condition. An estimated 600,000 people in the United States have tardive dyskinesia, and that number is expected to increase with the expanding use of dopamine receptor blocking agents (DRBAs) for various conditions. Experts agree that all patients who have been prescribed DRBAs should be screened for TD at every clinical encounter, regardless of the degree of risk of tardive dyskinesia.

Free CME/CE Activities on Tardive Dyskinesia
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Encore Presentation
Moving in the Right Direction: An Update on the Diagnosis and Treatment of Tardive Dyskinesia
CME/CE Credit: 0.75  |  Expires: November 6, 2025

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Mechanism of Action Animation
Mechanism of Action: The Etiology of Tardive Dyskinesia
CME/CE Credit: 0.25  |  Expires: October 17, 2025

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CNS Spectrums CME/CE Article
A New Era in the Diagnosis and Treatment of Tardive Dyskinesia
CME/CE Credit: 1.00  |  Expires: October 1, 2025

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Expert Clinical Case
62-Year-Old Mother With Schizophrenia Who Feels Embarrassed By Her “Shakiness”
CME/CE Credit: 0.50  |  Expires: July 31, 2025

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Mental Health News and Research
Screening for Tardive Dyskinesia
Published June 29, 2022

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Encore Presentation
Sitting Still: Strategies for Effective Symptom Management in Tardive Dyskinesia
CME/CE Credit: 0.75  |  Expires: February 26, 2025

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Mechanism of Action Animation
Mechanism of Action: Differentiating VMAT2 Inhibitors
CME/CE Credit: 0.25  |  Expires: October 25, 2025

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NEI Podcast
Episode 140 - Catch Me If You Can: Early Screening and Detection for Tardive Dyskinesia
CME/CE Credit: 1.00  |  Expires: March 23, 2025

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Encore Presentation
Move It on Over: Diagnosing and Treating Tardive Dyskinesia
CME/CE Credit: 1.00  |  Expires: April 24, 2025


Dopamine regulates motor movements through both the direct (go) and indirect (stop) pathways. In the direct pathway, dopamine released into the striatum binds to dopamine 1 receptors on GABA neurons. This stimulates GABA release, which ultimately leads to glutamate release in the cortex and thus enhances motor output. In the indirect pathway, dopamine released into the striatum binds to dopamine 2 receptors on GABA neurons. This inhibits GABA release, thus inhibiting the "stop" pathway and therefore also enhancing motor output.

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Figure 1. Chronic blockade of dopamine 2 receptors can lead to their upregulation; the upregulated receptors may also be supersensitive to dopamine. In the indirect (stop) pathway, this can lead to so much inhibition of the "stop" signal (left) that the "go" signal (right) is overactive, leading to the hyperkinetic involuntary movements of tardive dyskinesia.

Reference:

Stahl SM. Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 5th edition. Cambridge University Press; 2021.