Which statement best describes tardive dyskinesia and its monitoring?

• A. A sudden, reversible tremor that occurs immediately after starting an antipsychotic; monitor with a 12-lead ECG.
• B. Typically a mood-related side effect mitigated by antidepressants; monitor with the Hamilton Depression Rating Scale.
• C. A rare seizure disorder occurring only at high doses; monitor with EEG.
• D. Involuntary repetitive movements that often appear after long-term antipsychotic use; monitor with the Abnormal Involuntary Movement Scale (AIMS) and manage by dose adjustment or switching agents, with VMAT2 inhibitors considered if persistent.

Answer: (D)

Tardive dyskinesia is a late-onset movement disorder that develops after prolonged antipsychotic treatment, characterized by involuntary, repetitive movements most often in the face, tongue, lips, or other body parts. Because these movements can become permanent, regular screening with the Abnormal Involuntary Movement Scale (AIMS) is essential to detect and track symptoms over time. If tardive dyskinesia occurs, the primary approach is to reduce the antipsychotic dose or switch to an agent with a lower risk of TD. If symptoms persist and are disabling, VMAT2 inhibitors such as valbenazine or deutetrabenazine can markedly reduce movements by modulating dopamine release in the brain. The other descriptions don’t fit tardive dyskinesia: a sudden tremor after starting an antipsychotic describes acute extrapyramidal symptoms, not tardive; mood-related side effects monitored with depression scales concern depressive states rather than TD; a rare seizure disorder monitored with EEG reflects a different condition altogether.