A case presented a 28-year-old female with osteogenesis imperfecta and major depressive disorder with psychotic features, who developed tardive dyskinesia (TD) after taking a low-dose second-generation antipsychotic, risperidone (2 mg), for three months. Despite discontinuing risperidone and switching to quetiapine, her symptoms, including akathisia, dystonia, involuntary movements, and lip smacking, persisted, leading to a diagnosis of TD. This case is noteworthy as TD is less commonly reported with low-dose monotherapy of second-generation antipsychotics, especially in younger patients.

The case highlights the need for further research to identify possible unrecognized factors contributing to TD and to better understand the role of second-generation antipsychotics (SGAs) in its development. While SGAs are generally associated with a lower risk of extrapyramidal symptoms and TD compared with first-generation antipsychotics, cases like this indicate that even low doses of SGAs like risperidone can lead to TD. The report emphasizes the importance of physicians being vigilant and conducting regular follow-ups when prescribing SGAs, even at low doses.

Reference: Rokon AE, Alsomali FA, Alrasheed MA, et al. Tardive Dyskinesia Following Low-Dose Risperidone. Cureus. 2022;14(12):e32319. doi: 10.7759/cureus.32319.