Tardive Dyskinesia

Abstract

Tardive syndromes (TS) are a group of related iatrogenic disorders characterised by persistent abnormal involuntary movements resulting from the use of dopamine receptor blocking medications, which are often used to treat psychiatric and gastrointestinal conditions. The most common of the TS is classic tardive dyskinesia, characterised by involuntary stereotypic movements in the mouth region such as lip smacking or pursing, chewing, facial grimacing and tongue movements. TS can be highly disabling, difficult to treat and have the potential to be permanent, making their prevention of paramount importance. The pathophysiological basis of the TS is poorly understood. Treatment options include oral medications, botulinum toxin injections and deep brain stimulation surgery. More research is needed to determine the best available treatment options and to identify new treatments.

Key Concepts

  • Tardive syndromes are a group of related iatrogenic disorders characterised by persistent abnormal involuntary movements.
  • They result from the long‐term use of dopamine receptor blocking medications, which are often used in the treatment of psychiatric and gastroenterological conditions.
  • Tardive syndromes can persist after discontinuation of the causative drug and have the potential to be permanent.
  • There are various forms of tardive syndromes, the most common of which is classic tardive dyskinesia, described as repetitive, rhythmic, involuntary movements that are typically present in the mouth region.
  • Elderly individuals, women, diabetics and non‐whites appear to be most vulnerable to the development of tardive dyskinesia.
  • Treatment options for tardive syndromes are limited, and more research is needed to determine the best available treatment strategies and to identify potential new therapies.

Keywords: tardive dyskinesia; dystonia; akathisia; neuroleptics; dopamine receptor blockers; metoclopramide; antipsychotics

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Further Reading

Hyde TM, Apud JA, Fisher WC and Egan MF (2008) Tardive dyskinesia. In: Factor SA, Lang AE and Weiner WJ, (eds). Drug Induced Movement Disorders, 2nd edn. Malden: Blackwell Publishing Inc.

Perez‐Lloret S and Merello M (2011) Tardive dyskinesias and other drug‐induced movement disorders. Uncommon Causes of Movement Disorders, 1st edn. Cambridge, MA: Cambridge University Press; 139–152.

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Lehosit, Jessica B, Pirmohamed, Fermina, Vijayakumar, Dhanya, and Cloud, Leslie J(Jan 2015) Tardive Dyskinesia. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0025808]