Tardive diskinesia: a clinical interpretation.
This paper discusses various clinical conditions with oral diskinetic movements and proposes, on the basis of clinical evidence, an interpretation of drug-induced oral diskinesia as a conditioned response to local aversive stimuli related to drug use (local side effects), or other factors such as missing teeth and ill-fitting dentures. There is an accompanying anxiety associated with the aversive stimulus or with difficulties in verbal expression, as in the case of brain damaged patients. The diskinetic movements are initially Voluntary movements aiming at removing the aversive stimulus (stage of voluntary movements). If they succeed in reducing the accompanying anxiety, the reduction of anxiety reinforces the diskinetic response. In a subsequent stage, these movements lose their laborious voluntary quality and become automatic (stage of automatic movements). In a final stage, the diskinetic movements become instrumental in reducing anxiety in the absence of the aversive stimulus (stage of instrumentalization). The question is raised whether drug-induced oral diskinesia can be placed under the general rubric of tics, as a special drug-induced form of it.
Siomopoulos
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Illinois State Psychiatric Institute, 1601 West Taylor Street, Chicago, Illinois 60612, USA.
D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology; D003778:Dentures; D003863:Depression / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004409:Dyskinesia, Drug-Induced / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009055:Mouth / Q000503:physiopathology; D009068:Movement; D017755:Prosthesis Fitting; D014705:Verbal Behavior
D000928:Antidepressive Agents