Our study findings affirmed our hypothesis and supported the utility of the observation unit in monitoring the overall clinical status of patients, which was linked with subsequent inpatient admissions. Better management of these patients at the outpatient level can potentially decrease unnecessary hospitalization and reduce health care cost as well as illness burden on patients and caregivers.

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.