Tardive dyskinesia (TD) is a disorder that involves involuntary movements. Tardive means delayed and dyskinesia means abnormal movement. Show
TD is a serious side effect that occurs when you take medicines called neuroleptics. These drugs are also called antipsychotics or major tranquilizers. They are used to treat mental problems. TD often occurs when you take the drug for many months or years. In some cases, it occurs after you take them for as little as 6 weeks. Medicines that most commonly cause this disorder are older antipsychotics, including:
Newer antipsychotics seem less likely to cause TD, but they are not entirely without risk. Other drugs that can cause TD include:
Symptoms of TD include uncontrollable movements of the face and body such as:
When TD is diagnosed, the health care provider will either have you stop the medicine slowly or switch to another one. If TD is mild or moderate, various medicines may be tried. A dopamine-depleting medicine, tetrabenazine is most effective treatment for TD. Valbenazine is an alternative. Your provider can tell you more about these. If TD is very severe, a procedure called deep brain stimulation DBS may be tried. DBS uses a device called a neurostimulator to deliver electrical signals to the areas of the brain that control movement. If diagnosed early, TD may be reversed by stopping the medicine that caused the symptoms. Even if the medicine is stopped, the involuntary movements may become permanent, and in some cases, may become worse. TD; Tardive syndrome; Orofacial dyskinesia; Involuntary movement - tardive dyskinesia; Antipsychotic drugs - tardive dyskinesia; Neuroleptic drugs - tardive dyskinesia; Schizophrenia - tardive dyskinesia Aronson JK. Neuroleptic drugs. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier B.V.; 2016:53-119. Freudenreich O, Flaherty AW. Patients with abnormal movements. In: Stern TA, Freudenreich O, Smith FA, Fricchione GL, Rosenbaum JF, eds. Massachusetts General Hospital Handbook of General Hospital Psychiatry. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 21. Freudenreich O, Goff DC, Henderson DC. Antipsychotic drugs. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 42. Okun MS, Lang AE. Other movement disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 382. ul Haq I, Liebenow B, Okun MS. Clinical overview of movement disorders. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 105. Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Antipsychotic drugs, also known as neuroleptics, are mostly used to manage psychosis or symptoms like delusions (false beliefs) and hallucinations (seeing or hearing things that others don’t see or hear), according to the National Institute of Mental Health (NIMH). The drugs are often prescribed to treat bipolar disorder, schizophrenia, and schizoaffective disorder. NIMH states that antipsychotic drugs can also be used in combination with other medications to treat mental health conditions, such as:
Antipsychotics work by blocking dopamine receptors in the brain, according to the study in Neurotherapeutics. Dopamine is a neurotransmitter that not only helps control the part of the brain that signals reward and pleasure but also plays a big role in coordinating muscle movements. Other medications that can cause tardive dyskinesia include antidepressants, antiemetics (used for severe nausea and acid reflux), and anxiolytics (used to treat anxiety), according to a review published in 2017 in the Ochsner Journal. The severity of tardive dyskinesia varies widely from person to person. Some people may not even be aware that they’re experiencing involuntary movements, nor are they bothered by them, says Nucifora. Other people, however, may develop speech, swallowing, and even breathing problems, which can make them feel embarrassed and uncomfortable, he says. “For more severe tardive dyskinesia, people will seek help … but many people accept tardive dyskinesia as part of their illness,” Nucifora notes. Tardive dyskinesia can look and feel different in each person. As a result, there are many misconceptions about the condition — and it can be difficult to separate the myths from the facts. Learn the truth here. Fact: The Risk of Developing Tardive Dyskinesia Increases the Longer You Take an AntipsychoticTardive dyskinesia primarily occurs as a side effect of long-term use of antipsychotic medications, according to the National Alliance on Mental Illness (NAMI). And, says Nucifora, higher doses of an antipsychotic can add to the likelihood of the condition. Although tardive dyskinesia can occur from short-term use, it usually doesn’t appear before the three-month mark, says Nucifora. Anhar Hassan, MBBCh, a neurologist at the Mayo Clinic in Rochester, Minnesota: “Tardive dyskinesia also rarely occurs after a single dose.” Because tardive dyskinesia is linked with long-term use of antipsychotics, NAMI recommends that people taking these medications be closely monitored and screened by their doctor. Myth: People Who Develop Tardive Dyskinesia Should Stop Taking Their Medicine ASAPAlthough you should talk to your doctor right away about any involuntary movements you’re experiencing, you shouldn’t stop taking the drug on your own, says Dr. Hassan. Halting medication without speaking to your doctor first can be risky, she says. Abruptly stopping antipsychotics can trigger a recurrence of your psychiatric symptoms or even withdrawal symptoms. And sometimes, reducing the medication can worsen the dyskinesia and make it more challenging to treat, she says. If your physician decides to change your current medication, the tardive dyskinesia may stop, says Hassan. And even if the symptoms don’t go away completely, says Nucifora, the progression of the disorder may be halted or slowed by switching drugs. Which antipsychotic does not cause tardive dyskinesia?Risperidone, olanzapine, quetiapine, and clozapine have a low risk of tardive dyskinesia. Newer agents, such as lurasidone, asenapine, iloperidone, and aripiprazole, might have a lower risk of tardive dyskinesia, possibly because of differences in dopamine blockage between these agents and FGAs.
Do antipsychotics cause tardive dyskinesia?Risk factors in developing tardive dyskinesia. Anyone taking antipsychotic drugs is at risk of developing TD. It's listed as a common or very common side effect for antipsychotic medication.
Which antipsychotics cause the most tardive dyskinesia?Medicines that most commonly cause this disorder are older antipsychotics, including:. Chlorpromazine.. Fluphenazine.. Haloperidol.. Perphenazine.. Prochlorperazine.. Thioridazine.. Trifluoperazine.. Which medications cause tardive dyskinesia?Medications that can cause tardive dyskinesia include:. Antidepressants and anti-anxiety medications.. Dopamine-receptor blockers (dopamine antagonists).. Lithium.. Malaria medications.. Neuroleptics (antipsychotic drugs or tranquilizers).. Antinausea medicines (antiemetics).. |
