“Miss B” had her first episode of schizophrenia 1 year ago. The symptoms included delusion of persecution toward her colleagues, delusion of reference toward her boss, auditory hallucinations, and visual hallucinations. Her psychotic symptoms improved after the first 3 months of therapy with aripiprazole 15 mg/day. However, she had irregular, involuntary, persistent, and repetitive movements of mouth and tongue after aripiprazole treatment for 1 month. These movements were very irregular, either in intensity or direction. The intensity of movements varied over time and ranged from mild to moderate. The direction of tongue movements was random, in any possible direction, either within the oral cavity or outside the mouth. Her oral dyskinesia was not relieved after the aripiprazole was tapered to 10 mg/day in the 6th month and 5 mg/day in the 9th month. After 3 months of 5 mg/day aripiprazole therapy, her oral dyskinesia had still not responded to biperidin 2 mg/day. Because of the possibility of aripiprazole-related oral dyskinesia, the antipsychotic was switched to paliperidone. The irregular movements improved, with gradual decline in intensity, frequency, and duration within 1 month. No significant cholinergic rebound symptoms or side effects were noted after the abrupt switch. Her psychotic symptoms still remained stable. The remission of dyskinesia remained after therapy of paliperidone for the next 3 months.