The pathophysiology of tardive dyskinesia (TD) involves prolonged dopamine receptor blockade, leading to receptor supersensitivity and oxidative damage in the striatum. This case report discusses a 62-year-old male patient presenting with involuntary tongue movements and a history of long-term antidepressant and mood stabilizer use. The patient exhibited moderate spontaneous tongue movements and mild distress, as assessed using the Abnormal Involuntary Movement Scale. Management included altering his medication regimen by switching to clonazepam and clozapine, performing coronoplasty to prevent trauma from tongue movements, and providing counseling to improve his psychosocial well-being. These measures significantly reduced the severity of his symptoms.

Preventive strategies include altering antipsychotic regimens, reducing dosages, and considering second-generation antipsychotics or vesicular monoamine transporter 2 inhibitors. The case underscores the importance of early diagnosis and comprehensive management, including collaboration between oral physicians and psychiatrists, to mitigate the functional and psychosocial impact of TD, particularly in geriatric patients.

Reference: Ruparelia P, Pandya U, Gill N, Verma O. Restless tongue: Lingual Tardive Dyskinesia – A rare case report. J Oral Biol Craniofac Res. 2022;12(1):99-101. doi: 10.1016/j.jobcr.2021.10.006.