Recognition and Treatment of Tardive Dyskinesia in Individuals with Intellectual Disability

Table 1

Summary of ID individuals treated with valbenazine for TD.

Case number (gender, age, and living situation)	ID severity	Significant comorbid diagnoses	Medications^a
			Antipsychotic	Other
Case 1; (M, 63 yr, group home)	Moderate cognitive impairment; nonverbal, caregiver-dependent for most ADLs	Psychiatric: major depressive disorder; Other: arthritis, anemia, GERD, hyperlipidemia, and Parkinson’s disease	Prior: quetiapine; Current: quetiapine	Prior: atorvastatin, benztropine, carbidopa-levodopa-entacapone, donepezil, duloxetine, escitalopram, memantine, omeprazole, pregabalin, and tramadol; Current: atorvastatin, benztropine, carbidopa-levodopa, donepezil, duloxetine, escitalopram, memantine, omeprazole, pregabalin, tramadol, and valbenazine
Case 2; (F, 63 yr, lives at home with caregiver)	Mild cognitive impairment; caregiver-dependent for some ADLs	Psychiatric: schizoaffective disorder (bipolar type); Other: diabetes (type 2), fibromyalgia, GERD, hyperlipidemia, hypertension, hypothyroidism, overactive bladder, and neuropathy	Prior: olanzapine, risperidone; Current: asenapine	Prior: benztropine, fluoxetine, gabapentin, levothyroxine, memantine, metformin, mirabegron, N-acetylcysteine, pantoprazole, simvastatin, and topiramate; Current: fluoxetine, levothyroxine, memantine, metformin, N-acetylcysteine, oxybutynin, pantoprazole, simvastatin, and valbenazine
Case 3; (M, 28 yr, group home)	Moderate cognitive and physical impairment; caregiver-dependent for mobility and most ADLs	Psychiatric: excoriation disorder, schizoaffective disorder (bipolar type); Other: ASD, hypertension, hypothyroidism, GERD, and seizures	Prior: quetiapine; Current: clozapine	Prior: clonazepam, famotidine, lamotrigine, liothyronine, N-acetylcysteine, pindolol, and valproate; Current: famotidine, lacosamide, lamotrigine, levothyroxine, lithium, N-acetylcysteine, pindolol, valbenazine, and valproate
Case 4; (M, 61 yr, group home)	Moderate cognitive impairment; caregiver-dependent for some ADLs	Psychiatric: depressive disorder, impulse control disorder, OCD, and schizophrenia (paranoid type); Other: diabetes (type 2), enuresis, hyperlipidemia, hypertension, hypothyroidism, GERD, glaucoma, and tachycardia	Prior: chlorpromazine, clozapine, haloperidol, quetiapine, risperidone, and thioridazine; Current: clozapine	Prior: atorvastatin, bethanechol, escitalopram, famotidine, lisinopril, memantine, N-acetylcysteine, and naltrexone; Current: atorvastatin, doxazosin, escitalopram, famotidine, glycopyrrolate, latanoprost, levothyroxine, memantine, N-acetylcysteine, pindolol, and valbenazine
Case 5; (M, 45 yr, lives at home with caregiver)	Mild cognitive impairment	Psychiatric: schizophrenia (paranoid type); Other: COPD, hepatitis C, and seizures	Prior: aripiprazole, brexpiprazole, haloperidol, olanzapine, quetiapine, risperidone, and ziprasidone; Current: clozapine	Prior: benztropine, buspirone, carbamazepine, citalopram, and fluoxetine; Current: duloxetine, gabapentin, and valbenazine

^aRelated to significant comorbid diagnoses. Abbreviations: ADHD, attention-deficit/hyperactivity disorder; ADLs, activities of daily living; ASD, autism spectrum disorder; COPD, chronic obstructive pulmonary disease; F, female; GERD, gastroesophageal reflux disease; ID, intellectual disability; M, male; OCD, obsessive-compulsive disorder; TD, tardive dyskinesia; yr, years.