This Delphi consensus study addresses inconsistent terminology around tardive dyskinesia (TD) and the broader group of tardive movement disorders caused by dopamine receptor blocking agents (DRBAs). The authors explain that TD was originally used to describe delayed-onset oral-buccal-lingual movements, but the term gradually expanded to include multiple tardive presentations, including tardive dystonia, akathisia, myoclonus, tics, tremor, and rare tardive pain. Because these conditions may differ in presentation, pathophysiology, and treatment response, inconsistent use of “TD” and “tardive syndrome” can create confusion in clinical practice, research, and treatment trials. To address this, the study convened an expert Delphi panel of movement disorder neurologists, psychiatrists, and a clinical researcher to establish clearer nomenclature.

Across the Delphi rounds, the panel reached consensus that “tardive syndrome” should be used as the umbrella term for the full group of persistent tardive disorders related to DRBA exposure. The authors recommend reserving “tardive dyskinesia” for the specific subtype involving oral-buccal-lingual stereotypy, with or without chorea of the extremities. They also recommend avoiding the abbreviation “TS” because it could be confused with Tourette syndrome. Overall, the paper argues that clearer terminology is more than a semantic issue: it can improve communication among clinicians, reduce misinterpretation in the literature, support more consistent diagnosis, and help distinguish tardive phenomenologies that may require different assessment and management approaches.

Reference: Frei K, Scott A, Caroff SN, et al. Tardive Dyskinesia versus Tardive Syndrome. What Is in a Name? Parkinsonism Relat Disord. 2025 Apr;133:107295. doi: 10.1016/j.parkreldis.2025.107295.

This case report describes a 52-year-old woman with schizophrenia who developed tardive sensory syndrome (TSS) after approximately 3 months of treatment with lurasidone. Her symptoms were notable for mandibular sensory paresthesia and pain, without the more commonly recognized abnormal involuntary movements often associated with tardive syndromes, such as orofacial dyskinesia, tremor, rigidity, dystonia, or bradykinesia. The patient had previously been treated with several antipsychotics, but lurasidone had most recently been started after olanzapine was discontinued because of weight gain. To rule out other causes, clinicians conducted an extensive evaluation, including laboratory testing, brain CT imaging, and dental consultation, all of which were unrevealing. Based on the clinical features and exclusion of secondary causes, TSS was suspected, and her baseline Extrapyramidal Symptom Rating Scale (ESRS) score was 18 before her antipsychotic regimen was changed.

After lurasidone was discontinued and the patient was switched to quetiapine, her sensory symptoms improved markedly. Within 1 month, her ESRS score improved by 65%, falling from 18 to 6, and by 6 months her pain had fully resolved, with a visual analog pain score of 0/10. The authors suggest that this may be the first reported case of TSS associated with lurasidone and review several possible mechanisms, including dopamine receptor effects, serotonergic involvement, and oxidative stress-related injury. They also note that although second-generation antipsychotics are often viewed as carrying a lower risk of tardive syndromes, they are not risk-free. Overall, the report highlights the importance of recognizing painful sensory symptoms as a possible tardive phenomenon and considering medication changes promptly when these symptoms emerge.

Reference: Lin MC, Chang YY, Lee Y, Wang LJ. Tardive sensory syndrome related to lurasidone: A case report. World J Psychiatry. 2023 Mar 19;13(3):126-130. doi: 10.5498/wjp.v13.i3.126.

Authors of a narrative review examine the current European landscape of tardive dyskinesia (TD) and argue that TD remains both common and underrecognized across the region. Drawing on limited European data supplemented by findings from other regions, the authors note that TD prevalence remains clinically meaningful even in the era of second-generation antipsychotics, with prior estimates suggesting rates of 22.3% in Europe and a global mean prevalence of 25.3%. They emphasize that diagnosis is often missed or delayed because of poor recognition of the full range of TD symptoms, lack of systematic screening, inconsistent use of diagnostic criteria and rating scales, and shortcomings in coding systems. This includes the absence of a distinct TD code in some countries. The authors also highlight that accurate diagnosis is complicated by the need to distinguish TD from other abnormal movement disorders, and that better training for psychiatrists and closer collaboration with neurologists could help improve detection.

The authors further underscore the substantial disease burden and quality-of-life impact of TD. TD may persist even after stopping the causative agent, increase healthcare use and costs, worsen outcomes related to the underlying psychiatric illness, and negatively affect physical, psychological, social, and vocational functioning. From the European perspective, the authors argue that care is fragmented because TD-specific guidelines are sparse, inconsistent, or absent, and access to newer treatments varies widely by country. Although VMAT2 inhibitors have the strongest evidence base, their availability in Europe is uneven, which may contribute to undertreatment. Overall, the authors call for pan-European guidelines, improved access to newer therapies, better clinician and patient education, more routine screening, and clearer International Classification of Diseases coding. They also emphasize the need for more Europe-based research to better define TD prevalence, burden, and best practices for management.

Reference: Colosimo C, Jain R, Duma K, Kurzeja A, Arango C. A European perspective on tardive dyskinesia. Eur Neuropsychopharmacol. 2026 Mar;104:112740. doi: 10.1016/j.euroneuro.2025.11.017. Epub 2025 Dec 19.