What are proposed mechanisms by which tardive dyskinesia (TD) may develop?

Updated: Oct 17, 2018
  • Author: James Robert Brasic, MD, MPH; Chief Editor: Selim R Benbadis, MD  more...
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Several mechanisms have been proposed by which TD may develop, including the following:

  • Striatal dopamine receptor supersensitivity may be responsible

  • Chronic dopamine blockade may result in upregulation of dopamine receptor responsiveness

  • Compensatory supersensitivity of dopamine receptors may develop after long-term blockade; long-term blockade of dopamine D2 receptors in the basal ganglia by dopamine D2 antagonists (eg, neuroleptics) may produce TD

  • When dopamine D2 -receptor blockade is reduced (even slightly), an exaggerated response of the postsynaptic dopamine D2 -receptor (even to low concentrations of dopamine) may result

  • Striatal disinhibition of the thalamocortical pathway from imbalance of D1 and D2 receptors may be involved

  • Neurodegeneration secondary to lipid peroxidation or excitotoxic mechanisms may be responsible

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