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Tardive Dyskinesia

(TD)

Definition

Tardive dyskinesia (TD) is a movement disorder. It causes repeating movements that a person cannot control. TD may affect the face, limbs, or trunk.

It occurs from using certain antipsychotic medicines.

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Causes

TD is caused from long-term use of certain antipsychotic medicines.

It is not known why TD happens. Not all people who take these medicines get TD.

Risk Factors

TD is more common in women. It is also more common in older adults. Other things that may raise the risk are:

  • Use of antipsychotics that are:
    • Taken in high doses for longer than six months
    • The first drugs made to treat a condition
  • Symptoms that start or get worse after the medicine is stopped or the dose is lowered

Symptoms

Movements may be once and a while or all of the time. Symptoms may start while on the medicine or within weeks of stopping it.

A person may have:

  • Facial movements:
    • Chewing
    • Smacking, pursing, or puckering the lips
    • Frowning
    • Sticking out or twisting the tongue
  • Limb movements:
    • Flexing and extending the thighs
    • Foot tapping while sitting
    • Moving fingers as if playing the piano
    • Rubbing the hands together
  • Trunk movements:
    • Swaying the body
    • Pelvic thrusts

Diagnosis

The doctor will ask about your symptoms and health history. You will be asked about the medicines that you take. A physical exam will be done. This is enough to make the diagnosis.

Treatment

The goal of treatment is to stop movement problems. Choices are:

  • Lowering the dose or changing or stopping the medicine that is causing TD
  • Taking medicines to ease TD symptoms, such as vesicular monoamine transporter 2 inhibitors

Deep brain stimulation (DBS) may be used in people who are not helped by other methods. Electrodes are placed in the brain to help block or change abnormal activity.

Prevention

Talk to a doctor about the risks and benefits of medicines taken to treat mental health problems.

RESOURCES:

National Alliance on Mental Illness
http://www.nami.org

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

Canadian Mental Health Association
http://www.cmha.ca

Mental Health Canada
http://www.mentalhealthcanada.com

REFERENCES:

Bhidayasiri R, Fahn S, et al. Evidence-based guideline: treatment of tardive syndromes: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013 Jul 30;81(5):463-469.

Feinstein E, Walker R. Treatment of secondary chorea: a review of the current literature. Tremor Other Hyperkinetic Move (N Y). 2020:10:22.

Tardive dyskinesia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tardive-dyskinesia. Accessed January 12, 2021.

Last reviewed December 2020 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 1/12/2021