Neuroleptic-induced extrapyramidal side effects. I: Tardive dyskinesia

One of the major concerns about neuroleptic treatment is the possibility to induce long-term neurological side-effects called Tardive Dyskinesia costating in abnormal involuntary movements with a late onset that interest several body areas. In this literature review historical aspects, clinical presentation, diagnosis, epidemiology, physiopathology and treatment of this condition (that has influenced therapeutic strategies, in particular in American psychiatry) are reviewed and commented. A correct knowledge of risk factors, long-term outcome and treatment chances can help to reduce the risk for tardive dyskinesia induction and to manage antipsychotic therapy in the most convenient way when it appears. Original, preliminary data about new treatments of tardive dyskinesia, presented during the meeting 'Physiopathological and clinical aspects of neuroleptic-induced extrapiramidal disorders' held in Milan on November 24, 1993 at The S. Raffaele Hospital (I.R.C.C.S.) and organized by the Third Chair of Clihical Psychiatry of the Uhnversity of Milan and by I.R.G.A.S.D., are also reported.