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Historical perspectives on tardive dyskinesia

Published:February 03, 2018DOI:https://doi.org/10.1016/j.jns.2018.02.015

      Highlights

      • The core features of TD were recognized and well-described after the introduction of antipsychotic drugs over 60 years ago.
      • Controversies soon emerged as to its prevalence, reversibility, impact, and differentiation from psychomotor disorders.
      • Despite substantial progress, many original questions on the pathophysiology and management of TD merit further study.
      • Elucidation of the mechanisms underlying TD could offer insights into the nosology and pathophysiology of idiopathic psychomotor disorders and the mechanism of action of antipsychotic drugs.

      Abstract

      Tardive dyskinesia (TD) is a persistent hyperkinetic movement disorder associated with dopamine receptor blocking agents including antipsychotic medications. Although uncertainty and concern about this drug side effect have vacillated since its initial recognition 60 years ago, recent commercial interest in developing effective treatments has rekindled scientific and clinical interest after a protracted period of neglect. Although substantial research has advanced knowledge of the clinical features and epidemiology of TD, many fundamental questions raised by early investigators remain unresolved. In this paper, we review the early clinical reports that led to the acceptance of TD as an iatrogenic disorder and the lingering controversies that emerged thereafter. Continued research on TD as a serious adverse reaction to treatment may not only enhance patient outcomes and recovery efforts but may also provide insights into both the mechanism of action of antipsychotic drugs and the nosology and pathophysiology of idiopathic psychomotor disorders.

      Keywords

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