Psychiatry

Haloperidol is a first-generation antipsychotic medication that has the potential to cause tardive dyskinesia. Tardive dyskinesia is a hyperkinetic movement disorder that appears as a result of prolonged use of dopamine receptor blocking agents. Most commonly, tardive dyskinesia is related to antipsychotic medications or to metoclopramide. The onset of movements occur insidiously as early as one to six months following drug exposure. This condition impacts the face, mouth, tongue, trunk, or extremities and can include a mixture of orofacial dyskinesia, dystonia, athetosis, chorea, facial grimacing and tics. Patients with limited insight often do not report difficulties with tardive dyskinesia. In contrast, psychiatrically stable patients who are cognitively intact typically are aware of the manifestations of this disorder.Numerous studies have evaluated various pharmacologic treatments of tardive dyskinesia, but few therapies have produced more than slight to moderate benefit in clinical practice. Thus, prevention, early detection, and management of potentially reversible cases are the cornerstones of modern treatment. Although once considered a persistent or permanent condition, tardive dyskinesia is often reversible. Prognosis of tardive dyskinesia in patients who require continued antipsychotic drug treatment is not well established, but in most cases, tardive dyskinesia either remains unchanged or is suppressed by the hypokinetic effects of an antipsychotic drug if continued or reintroduced at a higher dose.