Antidepressant-induced tardive dyskinesia: review and case report

We report a case of clomipramine-induced tardive dyskinesia (TD) in the setting of chronic use of dextroamphetamine without prior use of neuroleptics, in which the movements persisted after discontinuation of the clomipramine. Other contributing factors include advanced age, history of alcohol abuse, and concomitant administration of hepatic enzyme inhibitors. Other cases of tricyclic-induced TD have occurred primarily in combination with neuroleptics, have involved antidepressants with antidopaminergic actions, or, as in the present case, have resulted from antidepressants with significant anticholinergic effects (n = 17). Predisposing risk factors and potential mechanisms in the precipitation of dyskinesias are discussed.