Understanding the risk factors for tardive dyskinesia (TD) and recognizing the features distinguishing it from other movement disorders is important for timely diagnosis and appropriate treatment.^1,2 During a virtual symposium at the 20^th WPA World Congress of Psychiatry, Professor Roongroj Bhidayasiri presented a session on understanding TD.

In this video, Prof. Bhidayasiri (University of North Chulalongkorn University Hospital, Bangkok, Thailand) discusses the risk factors and key symptoms of TD, and guidelines covering diagnosis. Explaining that TD can affect over 25% of people who take an antipsychotic (AP),³ he outlines the dopamine receptor hypersensitivity hypothesis, where blockade of D2 receptors on striatal neurons by AP drugs can lead to their upregulation, resulting in a net ‘go’ output in motor pathways.⁴ This mechanism is thought to explain the pathophysiology of TD.⁴

Prof. Bhidayasiri also explores differential diagnosis, focusing on the differences between TD and other movement disorders, such as drug-induced Parkinsonism. These movement disorders display different characteristics, including the timing of onset, type of motor symptoms, and reaction to changing AP dose or introducing anticholinergic medications.⁵ Prof. Bhidayasiri concluded by explaining that correct diagnosis is a vital factor in achieving optimal treatment for patients.