What is tardive dyskinesia?

Tardive dyskinesia is a drug-induced movement disorder in which sudden, uncontrollable movements happen in the face and body because of prolonged use of medication, typically anti-psychotic drugs. “Tardive” means delayed or late. Dyskinesia refers to abnormal, involuntary, or repeated muscle movements.

Tardive dyskinesia affects over 500,000 people in the United States. Females (especially post-menopausal women), older adults, and people of African descent have a higher risk of developing tardive dyskinesia.

Tardive dyskinesia symptoms

Tardive dyskinesia symptoms usually develop after you’ve taken a medication for months or years. Some people can develop the condition after as little as six weeks, but this is less common.

The condition causes different kinds of uncontrolled movements in the face, arms, legs, or torso.

Abnormal facial movements may include the following:

  • Blinking eyes rapidly
  • Chewing motions
  • Frowning or grimacing
  • Grunting
  • Puffing out cheeks
  • Smacking or puckering lips or making a sucking noise with the mouth
  • Sticking out the tongue or poking it into the inside of the cheek

Abnormal movements affecting the arms, legs, or torso may include:

  • Rocking the pelvis back and forth
  • Swaying from side to side
  • Tapping the feet
  • Waddling movement when walking
  • Wiggling or tapping the fingers (as if playing the piano)

In rare cases, tardive dyskinesia may affect breathing or cause the eyes to stick in a certain position (usually looking upward). Both of these symptoms require immediate treatment.

Causes of tardive dyskinesia

Long-term use of medications that block the activity of the chemical messenger (neurotransmitter) dopamine in the brain can cause tardive dyskinesia. These medications are used to treat psychiatric conditions, nausea, seizures, and other conditions. Experts do not yet know why these medications cause tardive dyskinesia in some people, while other people have no problems.

General groups of medications that can cause tardive dyskinesia include:

  • Neuroleptics (also known as anti-psychotics) used to treat psychiatric conditions, especially older versions of the drugs
  • Certain anti-depressants and mood stabilizers
  • Certain anti-nausea medications
  • Certain anti-seizure medications
  • Decongestants, such as pseudoephedrine and phenylephrine
  • Medications for movement disorders
  • Levodopa (used to treat Parkinson’s disease)

Tardive dyskinesia treatment

Symptoms of tardive dyskinesia may get better or disappear when you stop taking or lower the dose of the medication causing symptoms. Switching to another medication that is less likely to cause tardive dyskinesia may also reduce symptoms.

If changing medications doesn’t work or isn’t an option, your doctor may prescribe drugs to help to manage and improve symptoms. In cases where tardive dyskinesia affects breathing, doctors may recommend deep brain stimulation.

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