Drug-induced tardive dyskinesia

Drug-induced tardive dyskinesia, which occurs in the course of long-term administration of psychotropic drugs, especially neuroleptics, and persists for years even after drug removal, began to be reported in the late 1950s. Since then, more than 100 investigations on this subjects have been described. And it is estimated that 10 to 30 percent of long-term hospitalized psychiatric patients in Europe and North America exhibit tardive dyskinesia, whereas 5 to 20 percent of patients exhibit this syndrome in Japan. These findings suggest that the manifestation of tardive dyskinesia will become a serious problem in the investigation of psychotropic drug treatment. The author presents a review of the symptomatology, etiological factors, differential diagnosis, prognosis, and management of this syndrome. Results of the author's studies in the cross-national survey and on the reversibility of tardive dyskinesia are also described. In connection with biochemical theory of the etiology of tardive dyskinesia, a variety of therapeutic investigations have been carried out, but no successful therapy could be found among them. Therefore, the author stresses that the early diagnosis of dyskinetic symptoms, possible removal of responsible drugs, and preventive care in daily psychotropic drug treatment are regarded as extremely important in the management of this syndrome.