Case Studies & Conundrums: Practical Management of Tardive Dyskinesia for Psychiatric-Mental Health Nurses

Released On
December 14, 2018

Expires On
December 14, 2019

Media Type

Completion Time
75 minutes 

Psychiatry, Mental Health Nurses

Tardive Dyskinesia

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This activity is provided by Creative Educational Concepts, Inc..



Supported by an independent educational grant from Neurocrine Biosciences, Inc.


Credit Available

  • Nurses (ANCC) — 1.25 contact hours

All other health care professionals completing this course will be issued a statement of participation.

Target Audience

Psychiatric-mental health nurses and other healthcare professionals, who care for psychiatric patients at risk for tardive dyskinesia (TD).

Statement of Need

Sixty years after the introduction of antipsychotic medications, tardive dyskinesia (TD) continues to be a persistent and devastating side effect. TD is characterized by irregular movements of the perioral area, tongue, cheeks, and other regions of the face, fingers, and toes. Various facial movements, including excessive blinking, facial grimacing, and/or twisting or protrusion of the tongue may be present, as well as choreoathetoid movements of the trunk or extremities. The new VMAT2 inhibitors, valbenazine and deutetrabenazine, have reignited interest in the area and highlighted educational need for recognition and treatment. Psychiatric and mental health nurses assess their patients on chronic antipsychotic medications for new movement disorders and progression of TD symptoms. This program is directed to those providing direct patient care to help reinforceassessment skills to more accurately and quickly make a correct TD diagnosis, identify appropriate role for VMAT2 inhibitor use, and monitor treatment. We will also navigate dosing, drug interactions, and adherence, as well as troubleshoot pitfalls in the practical management of these new agents in your setting.

Learning Objectives

At the conclusion of this activity, participants will be able to:

  • Differentiate extrapyramidal symptoms (EPS) of pseudoparkinsonism, akathisia, and dystonia from chronic movements considered to be tardive dyskinesia (TD).
  • Revisit the short and long-term data of novel therapies for the treatment of tardive dyskinesia that have been FDA approved in the past 18-months and compare with existing non-FDA approved therapies with regard to efficacy/safety.
  • Using case examples, appraise criteria for use for VMAT2 inhibitors for tardive dyskinesia in appropriate patients and how treatment should best be initiated.
  • Evaluate best practices the advanced practice nurse may employ in the frontline management of TD, including use of concomitant medications (including anticholinergic agents), potential adverse effects, appropriate duration of therapy, and medication adherence.


Dawn M. Vanderhoef, PhD, DNP, PMHNP-BC, FAANP

Director, Psychiatric Mental Health Nurse Practitioner (Lifespan)
Specialty Assistant Professor & Academic Director
PMHNP Program Vanderbilt University School of Nursing
Nashville, Tennessee

Leslie L. Citrome, MD, MPH

Clinical Professor of Psychiatry and Behavioral Sciences
New York Medical College
Valhalla, New York

Jeannine S. Loucks, MSN, RN–BC PMH

Manager Emergency Care Center
St. Joseph Hospital Orange
Adjunct Professor University of California Irvine ‐ School of Nursing
Orange, California

Steven C. Stoner, PharmD, BCPP

Chair and Clinical Professor
University of Missouri–Kansas City
Kansas City, Missouri




Creative Educational Concepts is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Nursing (ANCC)
This activity is designated for 1.25 contact hour.

Learners are advised that accredited status does not imply endorsement by the provider or ANCC of any commercial products displayed in conjunction with an activity.


In accordance with the Food and Drug Administration, the speakers have disclosed that there is the potential for discussions concerning off-label uses of a commercial product/device during this educational activity.

Any person who may contribute to the content of this continuing education activity must disclose relevant relationships (and any known relationships of their spouse/partner) with commercial interests whose products or services are discussed in educational presentations. A com¬mercial interest is defined as an entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on patients. Relevant relationships include receiving from a commercial interest research grants, consultant fees, travel, other benefits, or having a self-managed equity interest in a company.

Disclosure of a relationship is not intended to suggest or condone any bias in any presentation but is made to provide participants with infor¬mation that might be of potential importance to their evaluation of a presentation.


Joan B. Fowler, PharmD, BCPP – has no relevant financial relationships to disclose in relation to the content of this activity.


Leslie L. Citrome, MD – has disclosed that he is a consultant for Acadia, Alkermes, Allergan, Intra-Cellular Therapeutics, Janssen, Lundbeck, Merck, Neurocrine Biosciences, Noven, Otsuka, Pfizer, Shire, Sunovion, Takeda, Teva, and Vanda. He is also a member of the speakers’ bureaus for Acadia, Alkermes, Allergan, Janssen, Lundbeck, Merck, Neurocrine, Otsuka, Pfizer, Shire, Sunovion, Takeda, Teva, and Vanda.

Jeannine S. Loucks, MSN, RN-BC PMH – has no relevant financial relationships to disclose in relation to the content of this activity.

Steven C. Stoner, PharmD, BCPP – has disclosed that he is a member of the speakers’ bureau for Neurocrine Biosciences.

Dawn M. Vanderhoef, PhD, DNP, PMHNP-BC, FAANP - has disclosed that she is a member of the speakers’ bureau for Neurocrine Biosciences.

Peer Reviewers

Laura Thiem, DNP, RN, FNP-BC, PMHCNS-BC, PMHNP-BC, CNE – has no relevant financial relationships to disclose in relation to the content of this activity.

Method of Participation

There are no fees to participate in the activity. Participants must review all activity information, including the learning objectives, disclosure statements, and content. To receive credit for participation, participants must complete the post-test (achieving a passing grade) and program evaluation. Certificates can be printed immediately.


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Supported Phones & Tablets:
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iPhone/iPad with iOS 6.1 or above.


The information presented in this activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician regarding diagnosis and treatment of a specific patient’s medical condition.

The opinions expressed in this educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.