Fast Five Quiz: Tardive Dyskinesia Risk Factors

Christoph U. Correll, MD; James Robert Brasic, MD, MPH


March 17, 2023

Antipsychotic medications, particularly conventional, typical, or first-generation antipsychotics (eg, chlorpromazine, mesoridazine, haloperidol), tend to be associated with prototypical orofacial TD. Atypical antipsychotics, such as risperidone, olanzapine, aripiprazole, and clozapine, appear to have a lower risk for TD.

Although TD has been observed after exposure to various substances, including central nervous system agents (such as levodopa), amphetamines, and prokinetic agents (such as metoclopramide), the prototypical TD is the orofacial (ie, buccolingual, masticatory) hyperkinesia induced by antipsychotic dopamine D2-receptor blockers, especially of the first generation.

Upon presentation of TD, clinicians should inquire about medications, including amphetamines, levodopa, and substances that may cause dyskinesias. Specifically ask whether antiemetic medications (especially metoclopramide, prochlorperazine, and related compounds) are being or have been administered.

Learn more about the diagnostic considerations of TD.


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