Tardive dyskinesia (TD) is a spectrum of hyperkinetic movement disorders associated with the use of dopamine receptor blocking agents. Among the dopamine receptor blockers, neuroleptics or antipsychotics have been the drugs most frequently associated with TD. The diagnosis of TD, as set forth by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision, requires ruling out other potential medical conditions; exposure to an antipsychotic for at least four weeks; and the presence of physical symptomatology. Involuntary athetoid or choreiform movements of the tongue, lips, face, and extremities are classic characteristics of TD and may appear one to two years into treatment with dopamine receptor blockers. Routine use of the Abnormal Involuntary Movement Scale (AIMS) is widely accepted for detecting or evaluating the severity of dyskinesia in patients receiving chronic antipsychotic therapies. The primary pathophysiology of TD is unknown; etiologies that have been investigated include dopamine receptor super-sensitivity, gamma-aminobutyric acid hypofunction, and neurodegeneration.,, Those who continued treatment for a further 42 weeks reported statistically significant reductions in their mean AIMS score (-3.0 in the 40mg group and -4.8 in the 80mg group) as well as reductions in the CGI-TD. The most common adverse events of Ingrezza were fatigue, sleepiness, constipation, dry mouth, headache, nausea, and vomiting., The effectiveness of Ingrezza improves with time, with maximal effectiveness reported at around 32 weeks for Tardive dyskinesia (TD) and up to 12 weeks for chorea associated with Huntington's disease (HD). Trials consistently report over 61% of participants as “much improved” or “very much improved” after 4 to 6 weeks treatment with Ingrezza 50mg to 80mg according to their CGI-TD score .