Drug-induced tardive syndromes

We reviewed the database of five Movement Disorders Units to establish drug s responsible for tardive syndromes or TS (tardive dyskinesia, dystonia, ak athisia, tremor, ties or tourettism, and myoclonus). The diagnostic criteri a for TS included: (1) appearance of persistent dyskinesia, dystonia, akath isia, tremor, ties or tourettism, or myoclonus, related to prolonged drug e xposure, (2) exclusion of other possible causes of these movement disorders . One-hundred patients fulfilled the diagnostic criteria for TS (26 males, 74 females, mean age 69.4 +/- 15.8 years). TS were related to 1,2, 3, 4 and 5 drugs in 58, 27, 9, 5 and 1 patients, respectively. The most frequently of fending drugs were antipsychotic drugs, substituted benzamides, thietylpera zine and calcium-channel blockers. Seventy-two patients had buccolinguomast icatory syndrome, 30 had tremor, 22 akathisia and 16 dystonia (35 patients had a combination of at least two of these TS). Forty-two patients had coex istent parkinsonism. The TS disappeared following withdrawal of the offendi ng drug in 40 cases. Old age and being female were more frequently associat ed with TS, with the exception of tardive dystonia. Substituted benzamides, calcium-channel blockers and thiethylperazine (a neuroleptic used for vert igo) were a frequent cause of TS in our series. (C) 1999 Elsevier Science L td. All rights reserved.