A 65-year-old patient is showing involuntary movements such as facial tics and lip-smacking. What condition is most likely suggested by these symptoms?

The symptoms described—such as involuntary movements, facial tics, and lip-smacking—are indicative of tardive dyskinesia. This condition is generally recognized as a side effect of long-term use of antipsychotic medications, especially the first-generation ones. The characteristic movements in tardive dyskinesia involve repetitive, involuntary muscle movements primarily affecting the face, lips, and tongue.

Risk factors for tardive dyskinesia also include older age, duration of therapy, and the use of higher doses of medication. This condition can significantly impact a patient’s quality of life due to the distress associated with the uncontrollable movements.

In contrast, Gilles de la Tourette's syndrome typically presents with motor and vocal tics that can wax and wane over time and originate in childhood. Huntington's disease involves chorea (uncontrolled movements), psychiatric symptoms, and cognitive decline, and is a hereditary condition. Schizophrenia may show a range of symptoms including delusions, hallucinations, and disorganized thinking, but the specific motor symptoms described are not characteristic of this disorder. Thus, the involuntary movements in this patient most closely align with tardive dyskinesia.