Tardive dyskinesia: review and update

Area of Science:

• Neuroscience
• Pharmacology
• Neurology

Background:

• Tardive dyskinesia is an extrapyramidal syndrome linked to long-term use of major neuroleptic medications.
• The underlying cause involves chronic blockade of striatal dopamine receptors, leading to denervation hypersensitivity.

Purpose of the Study:

• To review the pathogenesis and pathophysiology of tardive dyskinesia.
• To discuss current and potential therapeutic strategies for managing tardive dyskinesia.

Main Methods:

• Literature review of studies on neuroleptic-induced movement disorders.
• Analysis of the dopaminergic and cholinergic systems in the striatum.
• Evaluation of therapeutic interventions for tardive dyskinesia.

Main Results:

• Dopamine-depleting agents are the primary treatment for tardive dyskinesia.
• Cholinergic agents present a potential therapeutic avenue by modulating dopamine-acetylcholine balance.
• Reinstatement of neuroleptic therapy should be avoided due to its pathogenic role.

Conclusions:

• Understanding the dopaminergic and cholinergic pathways is crucial for treating tardive dyskinesia.
• Current treatments focus on reducing dopaminergic activity, with cholinergic agents offering future possibilities.
• Avoiding the causative agent, neuroleptics, is paramount in managing tardive dyskinesia.