To the Editor.—
Transient symptoms of tardive dyskinesia have been described in patients with Tourette's syndrome during and after treatment with neuroleptic agents.1-3 To our knowledge, this is the first report of a patient with Tourette's syndrome who developed persistent tardive dyskinesia following neuroleptic withdrawal.
Report of a Case.—
The patient, a 32-year-old man, first exhibited repetitive head and neck jerks at the age of 6 years. By the time he was diagnosed at the age of 21 years as having Tourette's syndrome, his symptoms included severe motor and phonic tics and obsessional thoughts. Haloperidol therapy was started at 1 mg/d, and gradually was increased over a ten-year interval to 7 mg/d. Although his tics were minimal at this dosage, the patient was dissatisfied with the haloperidol because of persistent insomnia, gastrointestinal discomfort, depression, mild tremors, and muscle spasms. He sought a second opinion and a decision was