In the Aftermath of Erwadi Incident

60's (Brandup, 1961) with few reports scattered in each subsequent decade. However, there has been a resurgence of interest in this drug in recent years (Sachdev, 2000; Ondoetal., 1999; Jankovic & Beach, 1997), a probable consequence of failure of other heuristic approaches to deliver the goods. To conclude, given the dramatic benefit shown in this case and the relatively poor efficacy of traditional treatments for TD, it is felt that tetrabenazine should be considered in all cases of severe and refractory TD. However, a caveat is the occurrence of adverse effects such as sedation, Parkinsonism, insomnia, akathisiaand depression, which may limit its use. Long-term systematic studies are encouraged to address this issue as well as to ascertain efficacy in Indian population. Moreover, Indian patients may require comparatively lower doses of tetrabenazine than their western counterparts, as indicated by our patient's response to a dose of 25 mg/day, which is considered to be the starting dose (Ondo et al., 1999). Hence, future trials with this drug are desirable.