Patient education: Tardive dyskinesia (The Basics)

What is tardive dyskinesia? — Tardive dyskinesia is a disorder that causes the body to make uncontrolled movements. It can make a person move their mouth, tongue, face, trunk, arms, or legs, even when they are not trying to.

This disorder is a side effect of taking certain medicines. It most often happens in people who have been taking medicines called antipsychotics, which are used to treat mental illness, such as schizophrenia. Sometimes, the disorder becomes permanent.

What are the symptoms of tardive dyskinesia? — People with tardive dyskinesia make movements they can't control.

●They sometimes:

•Make odd faces

•Stick out their tongue or move their tongue around

•Pout, pucker, or smack their lips

●They might twist or spread their fingers over and over again, or move them as though they are playing a piano.

●Their legs might make quick, jerking movements or slow, twisting movements.

●Their neck might twist at strange angles, or their hips might thrust.

The symptoms can be mild, and might be bothersome.

What causes tardive dyskinesia? — Tardive dyskinesia is a side effect of being on certain medicines for a while. Sometimes, it starts when the dose of the medicine is lowered, or when the medicine is stopped. The main medicines that cause it include:

●Antipsychotics, such as:

•Haloperidol (brand name: Haldol)

•Fluphenazine

•Risperidone (brand name: Risperdal)

•Olanzapine (brand name: Zyprexa)

●Metoclopramide (brand name: Reglan) – This is used to control nausea and vomiting and to treat acid reflux. Do not take this medicine for longer than 3 months at a time. There might be other medicines that can be used instead.

Will I need tests? — Probably not. If you have been on an antipsychotic medicine for at least a month and you show signs of tardive dyskinesia, the doctor or nurse will probably be able to tell what's wrong. Your doctor or nurse might order blood tests or brain scans to make sure that your symptoms are not caused by another problem.

How is tardive dyskinesia treated? — Some people only have mild symptoms and don't need treatment. For people who do, the treatment usually involves switching antipsychotic medicines or changing the dose. In some cases, the condition goes away or improves a little if the medicine that caused it is stopped. Unfortunately, it is not always possible to stop the medicine.

There are also medicines that can be given along with antipsychotic medicines that might help with tardive dyskinesia. If your doctor cannot control your tardive dyskinesia by switching your antipsychotic medicine or changing your dose, they might suggest adding other medicines, like:

●Benzodiazepines – These ease mild tardive dyskinesia symptoms in some people.

●Botulinum toxin (also called "Botox") – People who have abnormal movement only in certain body parts (such as the eyelids) can get injections of this medicine. It can help muscles relax and stop moving abnormally.

●Deutetrabenazine, tetrabenazine, or valbenazine – Your doctor might suggest trying one of these if you have severe symptoms that can't be treated with botulinum toxin.

People with severe tardive dyskinesia that does not improve with other treatments can sometimes get a treatment called "deep brain stimulation" ("DBS"). People who get DBS must first have surgery to place wires into a part of the brain that helps control muscle movement. The wires are attached to a device that gets implanted under the skin, usually near the collarbone. It sends electrical signals to the brain to reduce abnormal movement.

Can tardive dyskinesia be prevented? — Tardive dyskinesia is an unfortunate side effect of medicines that some people need to take to be well. Most people who take these medicines do not get tardive dyskinesia.

Still, there are certain things you can do to reduce the chances of getting the disorder or having a severe form of it. If you are on an antipsychotic medicine, watch out for abnormal movements. Tell your doctor right away if you notice any. The earlier the symptoms are found, the more likely it is that something can be done to prevent tardive dyskinesia from becoming permanent.

More on this topic

Patient education: Side effects from medicines (The Basics)
Patient education: Taking medicines when you're older (The Basics)
Patient education: Schizophrenia (The Basics)