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Tardive dyskinesia: Etiology and epidemiology

Daniel Tarsy, MD
Section Editor
Howard I Hurtig, MD
Deputy Editor
John F Dashe, MD, PhD


Tardive dyskinesia (TD) is a hyperkinetic movement disorder that appears with a delayed onset after prolonged use of dopamine receptor blocking agents, mainly the antipsychotic drugs (also called neuroleptics) and the antiemetic drug, metoclopramide [1,2].

TD has numerous clinical manifestations that include chorea, athetosis, dystonia, akathisia, stereotyped behaviors, and rarely tremor. The term "tardive" differentiates these dyskinesias from acute dyskinesia, parkinsonism, and akathisia, which appear very soon after exposure to antipsychotic drugs.

This topic will review the etiology and epidemiology of TD. Other aspects of this condition are discussed separately. (See "Tardive dyskinesia: Clinical features and diagnosis" and "Tardive dyskinesia: Prevention and treatment".)


TD is a unique complication of antipsychotic drugs and metoclopramide; convincing cases have not occurred after the chronic use of antidepressants or anti-anxiety medications [1,2].

Pathophysiology — The prolonged and often irreversible course of TD suggests that structural cellular alterations in the brain are responsible for the disorder. However, pathologic studies in laboratory animals and humans have failed to demonstrate consistent findings following chronic exposure to antipsychotic drugs [3].


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Literature review current through: Sep 2016. | This topic last updated: May 14, 2015.
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