What is a common management approach when tardive dyskinesia develops?

• A. Discontinue or switch the antipsychotic
• B. Increase dosage
• C. Add sedatives
• D. Continue unchanged

Answer: (A)

Tardive dyskinesia arises from long-term dopamine receptor blockade by antipsychotics, so the primary management is to reduce ongoing exposure by discontinuing the drug or switching to an antipsychotic with a lower TD risk. This change aims to address the underlying cause and prevent further progression, and if ongoing treatment is needed for psychosis, clinicians may choose the lowest effective dose or an agent with a safer TD profile. In some cases, newer options like VMAT-2 inhibitors can be considered if TD persists after stopping or switching, but the essential first step is to stop or swap the offending antipsychotic. Increasing the dosage, adding sedatives, or continuing unchanged does not address the root cause and is unlikely to improve TD; it may worsen symptoms or mask them without solving the problem.