Key takeaways
- Tardive dyskinesia (TD) is a movement disorder linked to neuroleptics, a type of antipsychotic drug. Some studies suggest 20 to 50% of people taking neuroleptics develop TD during treatment, and it can be permanent.
- TD often causes uncontrollable, repetitive movements in the face, torso, or limbs, like blinking, lip smacking, or toe tapping. If symptoms start while taking neuroleptics, talk with a doctor right away.
- Treatment often starts by adjusting the medication causing TD, such as lowering the dose, switching drugs, or stopping it gradually. In 2017, the U.S. Food and Drug Administration (FDA) approved valbenazine and deutetrabenazine to treat TD.
Tardive dyskinesia (TD) most commonly occurs as a side effect of taking neuroleptics, which are a type of antipsychotic drug prescribed for managing psychiatric, neurological, and sometimes gastrointestinal (GI) disorders.
Some research suggests that 20% to 50% of people taking neuroleptics will develop TD over the course of their treatment.
In some cases, TD may be a lifelong condition.
However, gradually discontinuing the medication that’s causing it or getting treatment after symptoms begin may prevent the condition’s progression or even reverse it.
Keep reading to learn more about the symptoms, causes, and treatment options for TD.
Symptoms of TD typically involve uncontrollable, repetitive, and writhing movements that
For example, you may experience some of the following movements:
- frequent blinking
- tight blinking
- smacking or puckering your lips
- sticking out your tongue
- puffing out your cheeks
- toe tapping
- swaying, side-to-side movement of the torso
- thrusting of the pelvis
- intense mouth or facial movements
Whether fast or slow, the uncontrollable movements associated with TD may interfere with your ability to work, perform day-to-day tasks, and stay active.
Some people experience an improvement of TD symptoms after stopping the medication that’s causing it, while for others, symptoms may remain. It’s unclear why some people improve and others do not.
See a doctor
If you begin to experience symptoms of TD and you’re taking neuroleptic medications, speak with a doctor right away. They may decide to reduce your dose or switch to a different drug to try and stop the symptoms.
TD is
Some medications associated with TD include:
- first-generation antipsychotics, such as:
- chlorpromazine (Thorazine)
- fluphenazine (Prolixin, Permitil)
- perphenazine
- prochlorperazine (Compro)
- haloperidol (Haldol)
- thioridazine
- trifluoperazine
- second-generation antipsychotics, such as metoclopramide (Reglan, Metozolv ODT) and aripiprazole (Abilify)
- antidepressant drugs, such as trazodone, amitriptyline, and fluoxetine
- antiseizure drugs, such as phenytoin and phenobarbital
According to a 2017 review, other medications that may cause TD, but don’t do so as often, include:
- anticholinergics
- antiemetics
- antihistamines
- decongestants
- antimalarials
- anxiolytics
- lithium
Not everyone who takes these medications will develop TD. However, your risk of developing TD increases the longer you take them.
At least
Symptoms of TD may appear
A doctor will first conduct a physical and medical history examination. They’ll want to see if any medications are causing your symptoms.
Then, they’ll assess your symptoms using the
- the severity of your movements
- whether you’re aware of the movements
- whether you’re in distress as a result of them
Symptoms can begin after you’ve been taking the causative medication for a short or a long period of time. Sometimes, TD symptoms can begin after you’ve stopped taking the drug.
The cause of TD, and therefore diagnosis, isn’t as obvious if symptoms begin after you’ve stopped taking the causative medication.
Healthcare professionals refer to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) to confirm a diagnosis of TD. Symptoms must continue for at least
The doctor may also order blood tests and brain scans to rule out other conditions that may cause atypical movements. These may include:
The treatment plan that’s right for you will depend on several factors, such as:
- how severe your TD symptoms are
- how long you’ve been taking a medication
- your age
- what medication you’re taking
- associated conditions, such as other neurological disorders
Prevention
The
- stopping to take the specific medication
- reducing your dosage
- taking a different medication that’s less likely to cause TD, such as clozapine
The National Alliance on Mental Illness (NAMI) recommends speaking with a doctor every 3 months for an examination of TD symptoms if you’re taking antipsychotic medications.
However, some research suggests that more frequent consultations, such as monthly, may be more effective in detecting TD earlier and preventing disease progression.
Medication
In 2017, the Food and Drug Administration (FDA)
These medications can affect some of the chemicals that resemble dopamine. This may play a role in how they affect symptoms, but researchers don’t fully understand exactly how they help control TD.
The drug clonazepam may also be prescribed short-term to help with muscle rigidity, according to the NAMI.
Living with TD may affect your physical, mental, and social well-being, but there are some ways to help cope with the condition and improve your quality of life.
These may include:
- joining an in-person or online TD support group
- using a fidget item when speaking with others
- managing stress, such as by practicing mindfulness, exercising regularly, and writing in a journal
- reaching out for support from a trusted friend, family member, or therapist
The best way to prevent TD is not to take medications that are associated with it. However, this isn’t always possible.
If a doctor prescribes a medication that increases the risk of TD, experts recommend taking the lowest effective dose for the shortest possible time to minimize the risk of TD.
If possible, it’s also recommended to have consultations with your doctor every 1 to 3 months to discuss how the medication is working and whether you’re experiencing TD symptoms.
Early TD diagnosis and management is key to preventing disease progression.
Some examples of TD may include:
- blinking frequently
- smacking or puckering your lips
- sticking out your tongue
- puffing out your cheeks
The medications that most commonly cause TD are neuroleptics, also known as antipsychotics. Other medications that may cause TD include:
- antidepressants
- anticholinergics
- antiemetics
- anticonvulsants
- antihistamines
- decongestants
- antimalarials
- anxiolytics
Some illegal stimulant drugs may also cause TD, including amphetamines, methylphenidate, and cocaine.
TD is a movement disorder that causes involuntary movements as a side effect of taking some types of medication, primarily neuroleptics.
Early diagnosis and treatment are key to managing symptoms and preventing long-term TD. But it’s important to note that symptoms of TD can be permanent. For some people, they may get worse over time, even after they stop taking the medication.
The best way to prevent persistent TD is to be aware of your body and any unusual symptoms you experience.
Speak with a doctor if anything unfamiliar occurs. Together, you can determine how to address the movements and underlying issues.