Tardive dyskinesia is characterized by
choreiform movements, or rhythmic abnormal
involuntary movements of the face, mouth, tongue, trunk, and limbs. It is frequently associated with the use of
neuroleptic medications. The
choreiform movements are irreversible in some patients, even after the
drug is withdrawn. Although no reliable treatment for
tardive dyskinesia exists, atypical
antipsychotics are associated with a significantly lower incidence of
tardive dyskinesia than typical
antipsychotics. Moreover, recent reports suggest that atypical
antipsychotics may have a beneficial effect on
tardive dyskinesia remission. Until recently, evidence for the effectiveness of
aripiprazole on
tardive dyskinesia has been mixed.
Aripiprazole has a unique mechanism of action and has various effects in
tardive dyskinesia. The
drug acts as a partial D(2) receptor agonist that can stabilize D(2) up-regulation, and as a partial
5-HT(1A) receptor agonist and a
5-HT(2A) receptor antagonist, and can increase the release of
dopamine in the striatum.