[Tardive dyskinesia: review of the literature]

Tardive Dyskinesia (TD) is an adverse effect of several psychotropic drugs for long-term therapy for schizophrenia and other psychoses. TD is considered an important issue for public health for its invalidating characteristics. An extensive review of the literature on studies concerning efficacious treatments for TD has been carried out.

A computer-generated search of the biomedical literature up to and including December 2002 was undertaken to identify studies.

Some evidence supports the switch from typical neuroleptics to atypical antipsychotics in patients with TD (particularly clozapine and olanzapine) and supports the use of atypical antipsychotics as first choice treatments. Other than the new antipsychotics, the gabaergic compounds, the new anticolinergics and some antioxidants as melatonin seem to be clinically useful. However, their tolerability and efficacy have to be confirmed by randomized clinical trials.

The recent introduction of atypical antipsychotics seems to reduce the risk of TD in patients with long-term and maintenance therapies. Available literature data show that TD is less frequent with the new antipsychotics but still remains a well-known complication. The future research sould be directed to confirm the efficacy of these new drugs and to offer other treatment opportunities for patients that cannot change typical with atypical antipsychotics or for patients where the onset of the TD appears during therapy with atypical compounds.