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Psych CASC / OSCEPsychopharmacology

Psych CASC / OSCE · Psychopharmacology

Explaining tardive dyskinesia and treatment options — CASC communication station

MRCPsych/FRANZCP-style station: explain TD in plain language, balance relapse risk vs movement harm, outline monitoring (AIMS), switch options, and evidence-based VMAT2 therapy without jargon dumps.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A 45-year-old woman with schizophrenia on long-term risperidone has new chewing and tongue movements. Her partner is angry, saying 'your medicine is poisoning her face,' and asks whether she must stop all antipsychotics forever and whether a 'new tablet for the movements' is experimental.

Station brief

Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar meeting the patient and partner in clinic after an AIMS assessment showed moderate orofacial TD.[1]

Candidate instructions. Explain tardive dyskinesia in plain language, acknowledge the link to dopamine-blocking medicines without abandoning hope, outline options (dose review, switch including possible clozapine pathway if psychosis requires ongoing treatment, VMAT2 inhibitors with trial-level evidence), and check understanding. Do not invent legal section numbers or claim SGAs never cause TD.[2][4][5]

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References5ShowHide
  1. [1]Correll CU, Citrome L Diagnostic and Treatment Fundamentals for Tardive Dyskinesia J Clin Psychiatry, 2021.PMID 34644461
  2. [2]Hauser RA, Factor SA, Marder SR, et al. KINECT 3: A Phase 3 Randomized, Double-Blind, Placebo-Controlled Trial of Valbenazine for Tardive Dyskinesia Am J Psychiatry, 2017.PMID 28320223
  3. [3]Anderson KE, Stamler D, Davis MD, et al. Deutetrabenazine for treatment of involuntary movements in patients with tardive dyskinesia (AIM-TD) Lancet Psychiatry, 2017.PMID 28668671
  4. [4]Carbon M, Hsieh CH, Kane JM, Correll CU Tardive Dyskinesia Prevalence in the Period of Second-Generation Antipsychotic Use: A Meta-Analysis J Clin Psychiatry, 2017.PMID 28146614
  5. [5]Ricciardi L, Pringsheim T, Barnes TRE, et al. Treatment Recommendations for Tardive Dyskinesia Can J Psychiatry, 2019.PMID 30791698
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