Tardive Dyskinesia

In the late 1960's I summarized the literature on tardive dyskinesia and found about forty-five papers on this disorder; when I reviewed this topic 4 years later there were fifty additional communications. It was hardly an impressive number ofreports and certainly small by comparison to the prolific output of psychopharmacologists in other areas. Yet there was sufficient information to be concerned about this new and unexpected complication. The majority of psychiatrists either ignored the existence of the problem or made futile efforts to prove that these motor abnormalities were clinically insignific­ ant or unrelated to drug therapy. In the meantime the number of patients affected by tardive dyskinesia increased and the symptoms became worse in those already afflicted by this condition. In the last 5 years papers on long-term neurologic side effects have become so numerous that one seldom finds an issue of a major psychiatric journal that does not contain at least one communi­ cation on tardive dyskinesia. Furthermore, many scientific meetings, national and international, have devoted symposia and workshops to this topic in recent years. There are several reasons why the profession has become so interested in the neurologic effects of neuroleptics. First, there are few investigators or clini­ cians who still have doubts about the iatrogenic nature of tardive dyskinesia. Second, the number of patients exhibiting motor abnormalities is increasing alarmingly, due to the cumulative effects of neuroleptics.