Tardive Dyskinesia: Symptoms, Causes, Diagnosis, and Treatment

Tardive dyskinesia (TD) is a movement disorder that causes uncontrolled, repetitive facial movements and behaviors, such as lip smacking, tongue wagging, and facial grimacing. It may also affect other body parts, such as the arms, legs, and trunk.

Symptoms

• Uncontrolled, purposeless, and repetitive movements, including:
  • Chewing or sucking motions
  • Grimacing (making faces)
  • Lip-smacking
  • Puckering or pursing of the lips
  • Rapid eye blinking
  • Tongue protrusion
  • Worm-like tongue movements
• Uncontrolled movements in arms, legs, and torso, such as:
  • Toe-tapping
  • Hip rocking
  • Uncontrollable finger movements, resembling playing an invisible guitar or piano

Causes

• Prolonged use of antipsychotic medications, including:
  • Typical antipsychotics, such as chlorpromazine, haloperidol, and thioridazine
  • Atypical antipsychotics, which have a lower risk but may still cause TD
• Other medications, such as certain antiepileptics, antidepressants, antiemetics, and anticholinergics

Risk Factors

• Women
• People over age 55
• People with diabetes
• People with mood disorders
• People with other neurological conditions

Diagnosis

• Physical examination and observation of symptoms
• Abnormal Involuntary Movement Scale (AIMS) to rate the severity of symptoms
• Ruling out other conditions with similar symptoms, such as Huntington's disease, cerebral palsy, Tourette's syndrome, and dystonia

Treatment

• Reducing or discontinuing the medication causing TD may resolve symptoms
• Medications:
  • Austedo (deutetrabenazine)
  • Botox (botulinum toxin)
  • Clozaril (clozapine)
  • Ingrezza (valbenazine)
  • Klonopin (clonazepam)
• Deep brain stimulation in severe cases
• Research is ongoing for new treatment options, including antioxidants like vitamin E, red rice bran oil, and curcumin

Coping

• Keeping detailed records of medications
• Joining support groups or online communities
• Inspire organization's support group for tardive dyskinesia