De novo Tardive Tourette-like syndrome after prolonged combination depot and oral neuroleptic therapy

Introduction: Tardive Tourette-like syndrome is recognised by the observation of several motor and vocal tics often in individuals receiving psychotropic medications and can happen within 1-3 months of treatment. Clinical case: We report a case which is unique in its onset of Tardive Tourette-like syndrome comprising of vocal, motor tics and coprolalia after more than three decades of treatment with combination depot and oral neuroleptics. Discussion: Use of the Naranjo Adverse Drug Reaction Probability Scale indicates a probable relationship between the onset of Tardive Tourettism and the antipsychotic therapy in this patient. This was in contrast to earlier reports which noted earlier onset and partial reversal with termination or change of medications. Clinicians need to pay heed to the emergence of late-onset Tourettism in order to better manage its manifestation and prevent its worsening in the context of holistic care for patients with neuropsychiatric conditions including schizophrenia.