Tardive dyskinesia in bipolar affective disorder: aging, cognitive dysfunction, course of illness, and exposure to neuroleptics and lithium.

Cognitive function, course of illness, and medication history were assessed in 42 bipolar patients evaluated for the presence of involuntary movements. Among the 25 patients 55 years old or older, the 16 with involuntary movements were not distinguished from the nine without involuntary movements by past or current exposure to neuroleptics, anticholinergics, or carbamazepine, but they showed poorer cognitive function, had fewer major depressive episodes, and had received briefer exposure to lithium. The association between involuntary movements and cognitive dysfunction parallels that found in schizophrenia, suggesting that similar neurological processes may contribute to vulnerability to involuntary movements in the major functional psychoses.