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Tardive Dyskinesia Litigation and the Dilemmas of Neuroleptic Treatment

The problem of liability over the occurrence of late side effects of neuroleptic treatment in mentally ill and mentally retarded patients has been underscored by four recent court decisions, in which enormous sums were awarded to plaintiffs who developed tardive dyskinesia. Four cases, Clites, Faigenbaum, Hedin, and Headley, are described in detail, and relevant issues in psychiatric malpractice are discussed. It is likely that the threat and the reality of tardive dyskinesia litigation will influence psychiatric practice in important ways. The gravity of the situation is compounded by the complexity of the medical issues, the potential numbers of litigants, and the structure of current psychiatric practice, which sometimes militates against careful adherence to established guidelines for the prevention of tardive dyskinesia.