Fast Five Quiz: Movement Disorders

Tardive dyskinesia can be caused by long-term treatment with dopamine antagonists. It can also be caused by both high-potency and low-potency traditional neuroleptics, including long-acting depot formulations (eg, decanoate and enanthate). Greater D₂ dopamine receptor blockade at the trough levels of the neuroleptics may be associated with a greater degree of tardive dyskinesia. Amisulpride has been associated with tardive dyskinesia; in general, however, newer atypical antipsychotic agents, including olanzapine and risperidone (and its metabolite paliperidone), appear to carry less risk for tardive dyskinesia.

The antiemetic metoclopramide, a potent D₂ dopamine receptor antagonist, may cause tardive dyskinesia, particularly in elderly patients. Tardive dyskinesia has also been reported with the use of antihistamines, fluoxetine, amoxapine (a tricyclic antidepressant), and other agents.

Table. Non-antipsychotic Medications Linked to Dyskinesias

Category	Agents
Anticholinergics	Benzhexol Biperiden Ethopropazine Orphenadrine Procyclidine
Antidepressants	MAOIs: phenelzine SSRIs: fluoxetine, sertraline Trazodone TCAs: amitriptyline, amitriptyline-perphenazine, amoxapine, doxepin, imipramine
Antiemetics	Metoclopramide Prochlorperazine
Antiepileptic drugs	Carbamazepine Ethosuximide Phenobarbital Phenytoin
Antihistamines	Various
Antihistaminic decongestants	Combinations of antihistamines and sympathomimetics
Antimalarials	Chloroquine
Antiparkinson agents	Bromocriptine Carbidopa-levodopa Levodopa
Anxiolytics	Alprazolam
Biogenic amines	Dopamine
Mood stabilizers	Lithium
Oral contraceptives	Estrogens
Stimulants	Amphetamine Methylphenidate Caffeine
MAOI = monoamine oxidase inhibitor; SSRI = selective serotonin reuptake inhibitor; TCA = tricyclic antidepressant.

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Helmi L. Lutsep. Fast Five Quiz: Movement Disorders - Medscape - Jul 08, 2021.

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