Withdrawal-emergent dyskinesia (WED) is a movement disorder that can develop following the sudden stop or quick reduction of antipsychotic medications, typically resolving within weeks. Highlighted by a case of a 13-year-old experiencing reversible oral dyskinesia during neuroleptic withdrawal and stimulant titration, this scenario stresses the need for heightened awareness among clinicians of potential extrapyramidal symptoms and withdrawal effects. This awareness is essential in managing the rising prescription of these medications to treat diverse psychiatric disorders in youth, aiming to prevent and handle complications effectively.

The case underlines the complexities of treating psychiatric conditions with antipsychotics and stimulants, particularly noting the challenges posed by rapid medication changes such as the discontinuation of ziprasidone and increased dosage of methylphenidate, which triggered oral dyskinesia due to dopamine receptor hypersensitivity. This example points out the critical need for careful medication management, including gradual tapering of doses. It is also a call for more research to deepen understanding of WED. Such studies will aid in developing refined strategies to prevent and manage this condition in pediatric psychiatric practice.

Reference: Haji Rahman R, Dharmapuri S. Oral Dyskinesia in a Pediatric Patient Following Concurrent Use of Neuroleptics and Stimulants: Treatment Strategy Considerations to Avert Avoidable Adverse Side Effects. Cureus. 2023;15(4):e38294. doi: 10.7759/cureus.38294.