Sydenham chorea (sc) is a complication of a group A beta-haemolytic streptococcal infection which is characterised by involuntary, choreatic movements. There is a definitive link between sc and psychoses. Furthermore, patients with sc seem to run a greater risk of developing neurolepticinduced movement disorders. In this case-study of a 19-year-old psychotic male with a history of sc, the authors illustrate that this complicates the treatment of a psychotic episode.