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Lancet Neurol. 2019 Sep;18(9):880-890. doi: 10.1016/S1474-4422(19)30152-8. Epub 2019 Jul 3.

Recent developments in drug-induced movement disorders: a mixed picture.

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Jean and Paul Amos Parkinson's Disease and Movement Disorders Program, Emory University School of Medicine, Atlanta, GA, USA. Electronic address:
Department of Neurology, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
Corporal Michael J Crescenz VA Medical Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Edmond J Safra Program in Parkinson's Research, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada.
Department of Neuroscience, Biomedicine, and Movement, University of Verona, Verona, Italy.
Department of Neurological Sciences, Rush Medical College, Chicago, IL, USA.


A large and ever-growing number of medications can induce various movement disorders. Drug-induced movement disorders are disabling but are often under-recognised and inappropriately managed. In particular, second generation antipsychotics, like first generation agents, are associated with potentially debilitating side-effects, most notably tardive syndromes and parkinsonism, as well as potentially fatal acute syndromes. Appropriate, evidence-based management is essential as these drugs are being prescribed to a growing population vulnerable to these side-effects, including children and elderly people. Prevention of the development of drug-induced movement disorders is an important consideration when prescribing medications that can induce movement disorders. Recent developments in diagnosis, such as the use of dopamine transporter imaging for drug-induced parkinsonism, and treatment, with the approval of valbenazine and deutetrabenazine, the first drugs indicated for tardive syndromes, have improved outcomes for many patients with drug-induced movement disorders. Future research should focus on development of safer antipsychotics and specific therapies for the different tardive syndromes and the treatment of drug-induced parkinsonism.

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