Tardive Dyskinesia

Excerpt

Tardive dyskinesia (TD) is a syndrome that encompasses a constellation of iatrogenic movement disorders caused by the antagonism of dopamine receptors. The movement disorders include akathisia, dystonia, buccolingual stereotypy, chorea, tics, and other abnormal involuntary movements. Most often, these dyskinetic disorders precipitate following chronic antipsychotic administration; however, several other medications are also associated with tardive dyskinesia. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) defines tardive dyskinesia as a medication-induced movement disorder that persists despite discontinuation or change of the medications. As per DSM-5, to confirm a diagnosis of tardive dyskinesia, symptoms must persist for at least one month after discontinuation of the medication.

Tardive dyskinesia is most common in people with schizophrenia and bipolar patients treated with antipsychotic medications but can occur in the setting of any disorder. In addition, the medications that precipitate tardive dyskinesia can also induce Parkinsonian symptoms. Although the precise pathogenesis continues to elude researchers, data suggest that tardive dyskinesia is induced by aberrant dopamine transporters.