Preventing neuroleptic-induced tardive dyskinesia in adults and children.

Neuroleptics remain useful in the treatment of schizophrenia, but tardive dyskinesia (TD) is a recognized serious side effect of long-term neuroleptic use in adults and children. Lack of proven effective treatment for TD makes prevention of TD a focus of clinical attention. In order to provide guidelines for the clinician, the literature regarding epidemiological risk factors for TD is reviewed. Clinical strategies for prevention of TD are discussed based on principles of: 1) being aware of risk factors for TD; 2) evaluating neuroleptic treatment; and 3) detecting early TD. The importance of patient participation in the clinical decision for long-term neuroleptic therapy cannot be overstressed.