The term
tardive dyskinesia has been used to refer to the TS that presents with rapid, repetitive, stereotypic movements mostly involving the oral, buccal, and lingual areas.
Tardive dystonia can be focal, segmental, or generalized. It commonly affects the face and neck followed by the arms and trunk. It usually results in retrocollis when it involves the neck and trunk arching backwards when it involves the trunk.
Tardive akathisia is characterized by a feeling of inner
restlessness and jitteriness with an inability to sit or stand still. Other tardive syndromes include tardive
tics,
myoclonus,
tremor, and withdrawal-emergent syndrome. It remains unclear whether tardive
parkinsonism truly exists. The only way to prevent TS is to avoid its etiologic agents. Chronic use of
dopamine receptor blocking agents should be limited as much as possible to patients with chronic
psychoses. In general, for mild TS, reducing the
neuroleptic dose, switching to an atypical agent, or discontinuing
antipsychotic treatment altogether in the hope of facilitating remission is recommended. For moderate to severe TS,
tetrabenazine or
reserpine may be the most effective agent.
Neuroleptics should be resumed to treat TD in the absence of active
psychosis only as a last resort for persistent, disabling, and treatment-resistant TD.
CONCLUSIONS: