Tardive Dyskinesia in Older Patients

Neuroleptic-induced tardive dyskinesia, which often appears in middle-aged and older adults earlyin the course of treatment with low doses of conventional antipsychotics, is 5 to 6 times more prevalentin elderly than in younger patients. In addition to age, other risk factors for tardive dyskinesia includeearly extrapyramidal symptoms (EPS), cumulative amounts of neuroleptics, duration of neuroleptictreatment, and history of alcohol abuse and/or dependence. The atypical antipsychotics, which have alow liability for EPS, are likely to also have low potential for tardive dyskinesia, despite the paucity ofcontrolled studies. Starting and maintenance doses of the atypical antipsychotics should generally belower in older than in younger adults.