Abstract
Tardive dyskinesia is a cluster of involuntary, irregular, hyperkinetic movements involving different muscle groups. Tardive dyskinesia, as a side effect, occurs in 15-20% of patients treated with antipsychotics. Complete remission is rare and occurs in 2% of patients after the treatment is discontinued. In case of tardive dyskinesia, switching to a second-generation antipsychotic and reduction of a dose over a few months should be considered. There have been also attempts to treat tardive dyskinesia with benzodiazepines, vitamin E, botulinum toxin and ondansetron. Tetrabenazine is a moderen and expensive, pharmacological option which is currently not registered in Poland. The course and effects of treatment with tetrabenazine in two patients with tardive dyskinesias are described. On the basis of our experience, gained during the tetrabenazine research program, we believe that the use of this drug should be limited to patients who are in stable mental condition, without any symptoms of depression or active psychotic symptoms. In our opinion, the presence of suicidal tendencies or thoughts and history of neuroleptic malignant syndrome are definite contraindications.