Clinical Phenotype of Tardive Dyskinesia in Bipolar Disorder

Manuel Gardea-Resendez, Monica J. Taylor-Desir, Francisco Romo-Nava, David Bond, Eric J. Vallender, Alfredo B. Cuellar-Barboza, Miguel L. Prieto, Nicolas Nunez, Marin Veldic, Aysegul Ozerdem, Balwinder Singh, Matej Markota, Colin L. Colby, Brandon J. Coombes, Joanna M. Biernacka, Susan L. McElroy, Mark A. Frye*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose Recognizing the negative impact that antipsychotic-induced movement disorders have on the quality of life and treatment outcomes in bipolar disorder (BD), this study aimed to assess clinical correlates and antipsychotic use patterns of tardive dyskinesia (TD+) in BD. Materials and Methods Participants with and without TD were included. Clinical variables were compared using t-test and χ2 test. Antipsychotic use patterns in TD+, including number of trials, mean doses, and estimated cumulative exposure, were assessed in a case-only analysis. Results The prevalence rate of TD was 5.1%. In comparison to the TD- group (n = 1074), TD+ participants (n = 58) were older, more likely to be female and have type I bipolar illness. There were 60.3% of the TD+ group that continued using antipsychotics at study entry and had a mean cumulative exposure to antipsychotics of 18.2 ± 15.6 years. Average dose, in haloperidol equivalents, was 5.9 ± 3.5 mg and 77.7% of the trials were second-generation antipsychotics. Conclusions This study confirms previously identified TD risk factors, such as age, sex, and bipolar subtype in a large BD cohort. Limitations included a cross-sectional design and the lack of tardive illness severity assessment. As atypical antipsychotics continue to be primary mood stabilization treatment, attempting to harmonize large data sets to identify additional biomarkers of tardive risk will optimize individualized care for patients with BD.

Original languageEnglish
Pages (from-to)159-162
Number of pages4
JournalJournal of Clinical Psychopharmacology
Issue number2
StatePublished - 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.


  • antipsychotics
  • bipolar disorder
  • tardive dyskinesia
  • Phenotype
  • Cross-Sectional Studies
  • Tardive Dyskinesia/chemically induced
  • Humans
  • Bipolar Disorder/chemically induced
  • Quality of Life
  • Female
  • Male
  • Antipsychotic Agents/adverse effects


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