Tardive Dyskinesia
Also known as: TD
Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive facial and body movements, most commonly caused by long-term use of dopamine-blocking medications such as antipsychotics. Movements often involve the face, tongue, and jaw but can affect the limbs and trunk. Early recognition and medication adjustment are critical, and FDA-approved treatments are now available.
Symptoms
Causes
- Prolonged use of dopamine receptor-blocking medications, especially first-generation antipsychotics
- Dopamine receptor hypersensitivity from chronic blockade
- Antiemetic medications such as metoclopramide
Risk Factors
- Duration and dose of antipsychotic medication
- Older age, especially postmenopausal women
- Female sex
- History of mood disorders
- Substance use disorder
- Use of first-generation antipsychotics
Diagnosis
- Clinical observation of characteristic involuntary movements
- Abnormal Involuntary Movement Scale (AIMS) assessment
- Medication history review
- Ruling out other movement disorders such as Huntington's disease
Treatment
- VMAT2 inhibitors such as valbenazine or deutetrabenazine (FDA-approved treatments)
- Switching to a lower-risk antipsychotic if possible
- Gradual dose reduction of the causative medication under medical supervision
- Avoiding abrupt discontinuation which may temporarily worsen symptoms
Prevention
- Using the lowest effective dose of antipsychotic medications
- Regular monitoring for early signs of involuntary movements
- Preferring second-generation antipsychotics with lower TD risk when appropriate
- Periodic reassessment of the need for antipsychotic therapy
When to See a Doctor
- Any new involuntary movements while taking antipsychotic or antiemetic medications
- Movements that persist after stopping medication
- Symptoms affecting eating, speaking, or daily functioning
Frequently Asked Questions
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