Tardive Dyskinesia

1. Tardive dyskinesia is an involuntary movement disorder involving the tongue, mouth, fingers, toes, and other body parts.

2. Tardive dyskinesias are characterized by chewing movements, smacking and licking of the lips, sucking movements, tongue protrusion, blinking, grimaces and spastic facial distortions.

3. All neuroleptics with the exception of clozapine produce tardive dyskinesia. The risk of tardive dyskinesia with novel antipsychotics is unclear, but appears to be substantially decreased.

4. Antiparkinsonian drugs are of no benefit for tardive dyskinesias and may exacerbate the symptoms of tardive dyskinesia.

5. When tardive dyskinesia symptoms are observed, the offending drug should be discontinued. Patients who require continued neuroleptic therapy should be switched to clozapine.

6. The risk of tardive dyskinesia increases with the duration of neuroleptic exposure, and there is an incidence of 3% per year.

7. Most patients have relatively mild cases, but tardive dyskinesia can be debilitating in severe cases. Tardive dyskinesias do not always improve with discontinuation or lowering of the dose of neuroleptic.

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