Table 1.
Characteristic | DIP | TD |
---|---|---|
Onset | Immediate (hours–days–weeks) after initiation of an antipsychotic or after dose is increased | Delayed (months–years) after initiation of an antipsychotic |
Motor symptoms observed | Rhythmic tremor, rigidity, shuffling gait; akathisia may be present | Arrhythmic movements (generally choreo-athetoid) of the face, trunk and extremities |
Immediate (hours–days–weeks) effects of increasing antipsychotic dose | Worsens | Improves |
Immediate (hours–days–weeks) effects of decreasing antipsychotic dose | Improves | Worsens |
Effects of anticholinergic medications (e.g., benztropine) | Improves | Can worsen |
Pharmacotherapeutic treatment options | Anticholinergics (for example, benztropine), amantadine | VMAT2 inhibitors (tetrabenazine, valbenazine, deutetrabenazine), Ginkgo biloba, clonazepam, amantadine |
VMAT2 vesicular monoamine transporter 2