Abstract
Most clinicians relate parkinsonism and dyskinesia directly to acute and tardive drug-induced movement disorders. However, parkinsonism and dyskinesia are also present in antipsychotic-naive patients with psychotic disorders. In this paper, we want to highlight the clinical value of these spontaneous movement disorders and want to discuss the concept of “non-mental signs.”
Highlights
Most clinicians relate parkinsonism and dyskinesia directly to acute and tardive drug-induced movement disorders
A causal relationship between these movement disorders and antipsychotics is beyond any doubt if (i) antipsychotic-naïve psychotic patients without movement disorders receive antipsychotics and develop these side effects, (ii) they disappear after dose reduction or cessation of the antipsychotics, and (iii) this on–off mechanism can be repeated
The prevalence of drug-induced tardive dyskinesia is substantial and increases with age, the same counts for spontaneous movement disorders such as dyskinesia, bradykinesia, and soft neurological signs related to schizophrenia [2,3,4,5,6,7,8,9,10,11,12,13,14,15]
Summary
Most clinicians relate parkinsonism and dyskinesia directly to acute and tardive drug-induced movement disorders. Spontaneous hyperkinetic dyskinesias, such as “grimacing” and “irregular movements of tongue and lips” (and parkinsonism), are prevalent in antipsychoticnaïve psychotic patients and have been described by Kraepelin and Bleuler more than a 100 years ago [1]. A meta-analysis showed that in antipsychotic-naïve patients with schizophrenia the risk of dyskinesia and parkinsonism are three and five times higher than in healthy controls, respectively [16].
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