Tardive dyskinesia: The Daily PANCE Blueprint

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Tardive dyskinesia: The Daily PANCE Blueprint

A 55-year-old woman with a history of schizophrenia has been on a stable dose of haloperidol for the past 10 years. Recently, she developed involuntary, repetitive movements of her mouth and tongue. Which of the following is the most likely mechanism responsible for her symptoms?

A. Increased dopamine synthesis in the nigrostriatal pathway
B. Chronic blockade of D2 dopamine receptors
C. Increased cholinergic activity in the basal ganglia
D. Progressive neurodegeneration of the substantia nigra
E. Development of autoimmune antibodies against dopamine receptors

Answer and topic summary

The answer is B. Chronic blockade of D2 dopamine receptors

Chronic blockade of D2 dopamine receptors in the nigrostriatal pathway is the primary mechanism underlying tardive dyskinesia (TD). Long-term use of antipsychotic medications, particularly first-generation antipsychotics like haloperidol, leads to upregulation and hypersensitivity of dopamine receptors, resulting in the characteristic involuntary movements of TD. Tardive dyskinesia is a common side effect of long-term antipsychotic therapy and can persist even after the discontinuation of the offending medication.

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Covered under ⇒ PANCE Blueprint Neurology ⇒ Movement Disorders (PEARLS) ⇒ Tardive dyskinesia

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