Tardive Dyskinesia Symptoms and Treatment

Tardive dyskinesia causes repetitive, involuntary, and purposeless movements

Tardive dyskinesia illustrated in a photo of a man
What is tardive dyskinesia, what are they symptoms and causes, and how might it be treated?. Getty Images - WIN-Initiative

Tardive dyskinesia is a movement disorder caused by long-term use of neuroleptic drugs as well as other drugs that increase the brain's sensitivity to the neurotransmitter dopamine. Tardive dyskinesia is characterized by uncontrolled facial movements such as repetitive tongue movements, chewing or sucking motions, and making faces.

Symptoms of Tardive Dyskinesia

Tardive dyskinesia causes repetitive, involuntary, and purposeless movements such as:

  • Fine, worm-like movements of the tongue
  • Lip smacking
  • Chewing or sucking movements
  • Grimacing (making faces)
  • Puckering or pursing the lips
  • Tongue protrusion
  • Rapid eye blinking

You may also experience uncontrolled arms, leg, and body movements. In some cases, uncontrollable finger movements may also occur, making it appear as though you are playing an invisible guitar or piano.

Drugs Known to Cause Tardive Dyskinesia

Tardive dyskinesia is a very serious side effect of antipsychotic medications, mainly typical antipsychotics, and atypical antipsychotics. Drugs in these categories that can cause tardive dyskinesia include:

  • Abilify (Aripiprazole)
  • Clozaril (Clozapine) (may also treat the condition)
  • Geodon (Ziprasidone)
  • Haldol (Haloperidol)
  • Loxitane and Loxapac (Loxapine)
  • Mellaril (Thioridazine)
  • Navane (Thiothixene)
  • Orap (Pimozide)
  • Piportil (Pipotiazine)
  • Prolixin and Modecate (Fluphenazine)
  • Risperdal (Risperidone)
  • Serentil (Mesoridazine)
  • Seroquel (Quetiapine)
  • Stelazine (Trifluoperazine)
  • Thorazine (Chlorpromazine)
  • Trilafon (Perphenazine)
  • Zyprexa (Olanzapine)

Some of the non-neuroleptic drugs that may also cause tardive dyskinesia are:

  • Asendin (Amoxapine)
  • Cocaine and other street drugs
  • Elavil (Amitriptyline)
  • Lithium
  • Nardil (Phenelzine)
  • Prozac (Fluoxetine)
  • Reglan (Metoclopramide)
  • Sinequan (Doxepin)
  • Tofranil (Imipramine)
  • Zoloft (Sertraline)

Ironically, neuroleptic drugs are dopamine antagonists, meaning they block dopamine receptors on nerve cells. However, over time this can cause the brain to compensate by creating more dopamine receptors and making them more sensitive, which can lead to serious side effects.

Tardive Dyskinesia Treatment

If you've been diagnosed with tardive dyskinesia, decreasing the dosage or discontinuing the medication causing the condition may solve your problems. However, it can also cause symptoms to worsen. If they do get worse, they may eventually go away, or they may continue indefinitely. For the best outcome, it is important to get diagnosed as early as possible.

A number of medications have been used to try to control the symptoms of tardive dyskinesia including Clozaril (clozapine), Botox (botulinum toxin), benzodiazepines such as Klonopin (clonazepam), and several others. For those with severe symptoms, deep brain stimulation (more commonly used with Parkinson's disease) may also be tried. Treatment is not always successful.

Fortunately, researchers are looking for new ways to treat tardive dyskinesia, which may include antioxidants such as vitamin E, red rice bran oil, and curcumin.

Living With Tardive Dyskinesia

Always keep detailed records of any medications you are taking—when you start them, what the dosage is, and any dosage changes. If you begin to experience any of the symptoms listed above, speak with your doctor and share your prescription history with them.

While your prescribing doctor should have your medication history, he or she may not have it in a compact form or you may not be able to visit that particular doctor if you need assistance in a hurry. It's also possible that your psychiatrist will notice symptoms of tardive dyskinesia before you are aware of them.

Coping with tardive dyskinesia can feel difficult and stigma associated with the condition's repetitive movements, isolating. If you feel alone, consider joining a support group or online support community. It can help to share your frustrations, especially among those who understand what you are going through. Inspire, an organization known for its many support communities has a group specifically for those living with tardive dyskinesia.

Sources:

Shireen, E. Experimental Treatment of Antipsychotic-Induced Movement Disorders. Journal of Experimental Pharmacology. 2016. 8:1-10.

U.S. National Library of Medicine. Medline Plus. Tardive Dyskinesia. 2016.

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