Treatment of neurolept-induced tardive dyskinesia

Figures & data

Table 1 Differential diagnosis of tardive dyskinesia

1. Huntington’s disease

2. Hepatolenticular degeneration (wilson’s disease)

3. Drug-induced dyskinesias, eg, levodopa, lithium, SSRI, TCA

4. Edentulous orodyskinesia

5. Spontaneous orofacial dyskinesia

6. Stroke

7. Immune-mediated chorea

Abbreviations: SSRI, selective serotonin reuptake inhibitor; TCA, tricyclic antidepressants.

Table 2 Risk factors for tardive dyskinesia^6,12–25

1. Age

2. Female sex

3. African-American race

4. Longer use and higher dose of neuroleptic agent

5. Preexisting mood disorder

6. Cognitive disturbance

7. Alcohol and substance abuse

8. Concomitant use of lithium and antiparkinsonian agents

9. Diabetes

10. HIV positivity

11. Typical neuroleptic agents

12. Early extrapyramidal symptoms

Abbreviation: HIV, human immunodeficiency virus.

Table 3 Hierarchy of strategies in the management of tardive dyskinesia

1. Slowly reduce neuroleptic dose

2. Add or change to clozapine, quetiapine, or risperidone

3. Add tetrabenazine, reserpine, or vitamin E

4. Deep brain stimulation

EberhardJLindströmELevanderSTardive dyskinesia and antipsychotics: a 5-year longitudinal study of frequency, correlates and courseInt Clin Psychopharmacol2006211354216317315

 PubMed Web of Science ®Google Scholar

MargoleseHCChouinardGKolivakisTTBeauclairLMillerRAnnableLTardive dyskinesia in the era of typical and atypical antipsychotics. Part 2: Incidence and management strategies in patients with schizophreniaCan J Psychiatry2005501170371416363464

 PubMed Web of Science ®Google Scholar

PatsopoulosNANtzaniEEZintzarasEIoannidisJPCYP2D6 polymorphisms and the risk of tardive dyskinesia in schizophrenia: a meta-analysisPharmacogenet Genomics200515315115815861039

 PubMed Web of Science ®Google Scholar