Antipsychotic-Induced Tardive Dyskinesia

Update on Epidemiology and Management

Christian G. Widschwendter; Alex Hofer


Curr Opin Psychiatry. 2019;32(3):179-184. 

In This Article


In conclusion, epidemiological data confirm the advantage of NGA over FGA with regard to tardive dyskinesia risk, which had been questioned by studies such as CATIE and CUtLASS. However, tardive dyskinesia still is prevalent and clinicians are encouraged to assume that tardive dyskinesia exists in their patients.

Importantly, antipsychotics should only be prescribed when a clear benefit can be expected and no safer or feasible alternative is available, notably for off-label use.

More detailed (prospective) studies, preferentially in FGA-naïve patients, with complete medication history and dose information are needed to properly estimate the tardive dyskinesia risk of NGA. Additionally, future comparative studies are needed to understand whether or not NGA differ among one another with regard to tardive dyskinesia risk.

Recent analyses for tardive dyskinesia treatment options are largely consistent with previous findings, which have revealed conflicting and limited evidence for most strategies. Similarly, prospective high-quality trials are needed to substantiate the benefits of most proposed treatments for tardive dyskinesia. Promising new therapy options such as the new VMAT2 inhibitors are reasonable to consider as first-line pharmacotherapy for tardive dyskinesia. However, their benefit in the real-world long-term treatment needs to be proven.