Riv Psichiatr. 2026 Jul-Aug;61(4):156-165. doi: 10.1708/4747.47642.
ABSTRACT
BACKGROUND: This survey aimed to investigate how physicians in Italy recognize, diagnose, and manage tardive dyskinesia (TD), as well as to assess and identify gaps in the current treatment approaches.
METHODS: A non-interventional cross-sectional online survey was conducted among Italian physicians who had managed patients with TD in the 1 year prior to the survey. The questionnaire explored physicians’ demographics, clinical experience, diagnostic methods, treatment strategies, perceptions of TD impact, and health care resource utilization related to TD. Data were summarized descriptively.
RESULTS: The survey included 70 psychiatrists and 30 movement disorder neurologists. Most patients presented with mild (49%) or moderate (35%) TD. Treatment strategies varied by TD severity; antipsychotic dose modification or switching was common, particularly to clozapine, quetiapine, and aripiprazole, whereas TD-specific add-on treatments such as tetrabenazine were rarely used (12% to 21% of physicians prescribed the treatment). Movement impairment was primarily assessed through patient or caregiver reports on quality-of-life impact, while standardized scales like the Abnormal Involuntary Movement Scale were underused, especially by psychiatrists. Physicians acknowledged significant challenges including a lack of highly effective treatments and an absence of specific Italian or European guidelines. TD was perceived as significantly affecting patients’ physical and psychosocial functioning and increasing health care resource utilization.
CONCLUSIONS: This study highlights variability and unmet needs in TD diagnosis and management among Italian specialists. Add-on treatments such as tetrabenazine are not considered standard of care in Italy due to lack of clinical practice guidelines, concerns around drug efficacy, adverse events, and overall treatment satisfaction.
PMID:42478307 | DOI:10.1708/4747.47642
