The authors describe 19 patients with severe tardive dyskinesia, 11 of
whom had a diagnosis of affective or schizoaffective disorder rather than
schizophrenia. Most patients had been receiving long-term neuroleptic
treatment with few interruptions and had received only one or two different
neuroleptics. Frequent eye blinking was the most prevalent prodromal sign
of tardive dyskinesia (in seven patients). Four subtypes of tardive
dyskinesia could be distinguished: choreoathetosis, tardive dystonia,
blepharospasm, and tardive akathisia. Optimal pharmacotherapy most often
consisted of combinations of neuroleptics, lithium carbonate,
benzodiazepines, and antiparkinsonian drugs. However, after an average of
62 months, only five patients had markedly improved.Abstract Teaser