Tardive Dyskinesia

What is tardive dyskinesia?

Tardive dyskinesia (TD) is a set of symptoms caused by the long-term use of certain medicines. These medicines, called antipsychotics, may be prescribed to treat:

• hallucinations (hearing and seeing things that are not there)
• delusions (false beliefs)
• mood swings
• paranoid thoughts (thinking that people are out to get you)
• agitation (getting overly excited, anxious, or angry for no reason)
• severe obsessive compulsive disorder (OCD)

What is the cause?

Certain medicines may cause TD by changing the balance of certain neurotransmitters in the brain. Newer antipsychotic medicines may be less likely to cause TD.

You are most at risk of developing TD if you take antipsychotic medicine and you:

• have taken it for a long time
• are taking high doses (particularly if you are an older adult)
• have recently stopped taking the medicine

What are the symptoms?

TD most commonly involves repetitive, involuntary movements such as:

• tongue thrusting
• lip smacking
• lip pursing
• grimacing and chewing movements
• rocking of the trunk
• pelvic thrusting
• rotating the ankles or legs
• marching in place
• irregular breathing
• frequent humming or grunting

Symptoms may start a few months to several years after you begin taking these medicines. The movements may be barely noticeable or quite obvious.

How is it diagnosed?

Your healthcare provider will ask about your medical history and examine you. Lab tests may be done to rule out other conditions. You might be given the Abnormal Involuntary Movement Scale (AIMS) test, or the Dyskinesia Identification System Condensed User Scale (DISCUS) test. These tests take just a few minutes and can be done every 6 months while you are using medicines that may cause TD.

How is it treated?

Your healthcare provider may reduce your dosage or replace the medicine you have been taking. The medicine may be replaced with newer antipsychotic medicines. Other medicines may be prescribed to help with TD symptoms.

How long will the effects last?

You may keep having symptoms of TD long after you stop taking the medicine that caused them. Some symptoms may improve or disappear with time.

What can be done to help prevent tardive dyskinesia?

As healthcare providers learn more about the chemistry of the brain, new medicines are being developed. These new medicines may not be as likely to cause TD symptoms.