Despite high hopes and expectations that modern antipsychotic drug therapy would finally come to grips with tardive dyskinesia (TD) and pave the way for its burial, this potentially irreversible complication remained a fearsome and challenging issue, particularly in older age groups. Long-term prevalence rates >20% are still reported even in patients never exposed to firstgeneration drugs. 1-3 The gospel of TD has taught generations that striatal dopamine D 2 receptors become supersensitive during antipsychotic drug treatment. In the interval, the body of research supporting this hypothesis in human TD has remained deceptively thin, only to promote the development of novel antipsychotic drugs lacking robust affinity and selectivity for D 2 receptors supposed to avoid TD. Evidently, this has not panned out yet. Unfortunately, drug management of moderate-to-severe TD remains limited, attributable, in large part, to knowledge gaps in pathophysiology. Alleviation of TD scores afforded by vesicular monoamine transporter type 2 (VMAT2) blockade with tetrabenazine, deutetrabenazine, and valbenazine 4 proved their clinical relevance and supported two basic points in TD: (1) relative integrity of VMAT2 function and (2) implication of dopamine signaling. The proportion of responders' rate (≥50% reduction in baseline TD scores on the Abnormal Involuntary Movements Scale) <50% with these drugs 5 is a good indicator of the challenge awaiting clinicians managing TD. In this brief article, we present recent molecular findings indirectly suggesting the presence of enhanced striatal dopamine signaling in TD beyond D 2 receptors and wish to call out researchers and clinicians in considering new dopaminergic and nondopaminergic targets to improve management through modulation of glycogen synthase kinase (GSK)-3 activity.The mechanisms underlying delayed induction and maintenance of TD, as well as susceptibility of elderly subjects, remain elusive. The research community has relied essentially on experimental rodent models in order to achieve progress in the field. The short-acting dosing methods used for drug exposure in rodents have been questioned, given that they yield excessive peak and rapid trough levels in accordance with the short half-life of haloperidol in rodents (2-3 hours) relative to humans (>24 hours). 6 Furthermore, the relevance of the brief 3-week drug exposure proposed to assess the resulting vacuous chewing movements (VCM) response has also been raised, susceptible to reflect acute extrapyramidal reactions rather than genuine TD, leading some groups to advocate an extension of the haloperidol exposure to 6 months with more continuous forms of drug delivery with the drinking water or long-acting intramuscular depot preparations, before conducting further experiments. 7,8 Differences in phenomenology between early versus late VCM responses are also difficult to appreciate, but the acute impact of a shortacting haloperidol injection on VCM scores and distinct striatal dynorphin mRNA expression have argued for late ...