A 52 year old woman is brought to the office with her adult daughter, who is concerned about her mother’s “tongue and lips glitching”.  The daughter states she was diagnosed with schizophrenia about 12 years ago but has not seen her for about five years. She says she wasn’t like this before and her mother never mentioned the “peculiar” movements. The patient’s psychotic symptoms have been control with oral and intramuscular depot antipsychotic agents. She recalls when she first started the medication she had problems with neck spasms and her head was “stuck to the left” but no other severe problems since then.

BMI 34
BP 145/89
HR 75
Temp 98.0
02 Sat 97%

Past medical history:

Social history:
No drugs, no alcohol, or recreational drug use
Tobacco use: One pack a day 15 years
Recent Widower 2 yrs ago

Family history:
Mother: Depression, HTN
Father: Unknown

1. What is your diagnosis?


2. What test(s) are you running to confirm your diagnosis?


3. What recommendation(s) do you have for the patient?

4. What medication(s) are risk factors for Tardive dyskinesia?


5. Who is at risk Tardive dyskinesia?


6. What are your primary treatment options?


7. What are some additional, complementary, and alternative medicine(s)?


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