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Tardive dyskinesia
Tardive dyskinesia is a serious neurological disorder caused by the
long-term use of traditional antipsychotic drugs. Neuroleptic drugs are
generally prescribed for psychiatric disorders, as well as for some
gastrointestinal disorders and neurological disorders. However, the new
generation of atypical antipsychotics appears to not cause tardive
dyskinesia.
Clinical presentation
Tardive dyskinesia is characterized by repetitive, involuntary,
purposeless movements. Features of the disorder may include grimacing,
tongue protrusion, lip smacking, puckering and pursing of the lips, and
rapid eye blinking. Rapid movements of the arms, legs, and trunk may
also occur. Impaired movements of the fingers may appear as though the
patient is playing an invisible guitar or piano. Many of the symptoms of
tardive dyskinesia appear similar to Parkinson's disease and the cause
of tardive dyskinesia appears to be related to the neurotransmitter
dopamine.
The phrase comes from tardive, which means "late" and dyskinesia
which means "abnormal movement".
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Treatment
There is no standard treatment for tardive dyskinesia. Treatment is
highly individualized. There is some evidence that benztropine or
diphenhydramine can prevent tardive dyskinesia, and these are often
given with antipsychotics. When tardive dyskinesia develops, the first
step is generally to stop or minimize the use of the neuroleptic drug.
However, for patients with a severe underlying condition this may not be
a feasible option. Replacing the neuroleptic drug with substitute drugs
may help some patients.
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