Stopping or adjusting medication is the first-line approach for reversing tardive dyskinesia. But other options, such as physical therapy, can help with symptom management.

Tardive dyskinesia (TD) is a neurological condition involving uncontrollable muscle movements primarily in your face, neck, and limbs. It’s caused by long-term use of medications that block dopamine receptors in your brain.

Antipsychotics, certain gastrointestinal medications, and medications used to treat Parkinson’s disease are often associated with TD. When used for extended periods of time, these medications can cause chemical abnormalities in the striatum of your brain, an area that contains many dopamine receptors.

Dysfunction in the striatum can lead to unusual motor control signaling, which causes involuntary muscle movements.

Symptoms of TD include uncontrollable jerking, twitching, and movement of the following parts of your body:

  • tongue
  • mouth
  • face
  • neck
  • legs
  • arms

TD is classified as a medication-induced movement disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision, along with tardive dystonia and tardive akathisia.

The exact prevalence of TD across all medications isn’t known. But the authors of a 2017 research analysis suggest that about 20% of people who take second-generation antipsychotics experience some symptoms of TD, with a higher prevalence in older adults.

The word “reversibility” in medical terminology refers to the ability to restore some level of baseline function by treating a condition. This term doesn’t always mean a condition is curable, but it suggests that, with treatment, function can be regained.

There’s currently no cure for TD, and if you develop it, the chances that treatment will fully reverse it are low. For example, in a small 2014 study involving 108 people with tardive syndromes, only 13% of the participants experienced reversibility.

While more research is necessary to provide a clear view of reversibility rates, a handful of options are available to help you regain function if you develop TD.

Discontinuing or reducing medication

The first-line approach for reversing the effects of TD is to stop or reduce the medication that is causing motor dysfunction.

But for many people, this isn’t an option. The medication you’re taking may be necessary to prevent a relapse of other impairing symptoms, such as psychosis.

Switching medications

If you cannot stop taking the medication that’s causing TD, you may be able to switch to a different medication.

For example, TD associated with antipsychotics is more prevalent with earlier formulations known as first-generation or typical antipsychotics. Newer formulations called atypical or second-generation antipsychotics pose less risk for TD.

Taking VMAT2 inhibitors

Vesicular monoamine transporter 2 (VMAT2) inhibitors, such as deutetrabenazine and valbenazine, work to balance dopamine levels and regulate dopamine release in your brain. They do this by inhibiting the protein VMAT2, which helps deliver neurotransmitters, such as dopamine, into neural networks.

Through this action, VMAT2 inhibitors may help reduce the symptoms of TD that stem from dopamine dysregulation.

Undergoing deep brain stimulation (DBS)

DBS is a neurological procedure that involves using electrodes implanted into your brain to provide electrical stimulation. The rhythmic electrical impulses from DBS can help your brain regulate its electrical system.

The authors of a 2023 research article state that DBS appears to be effective in TD and may help reduce the atypical neurological activity that contributes to motor dysfunction.

Taking gingko biloba extract

Ginkgo biloba extract is an herbal supplement obtained from the leaves of the gingko tree. It has been used in Eastern traditional medicine for centuries, for a variety of purposes.

A 2016 review of three studies involving people living with schizophrenia found that Ginkgo biloba extract held promise as an adjunctive therapy in TD and appeared to enhance symptom improvement.

A small 2023 study with 63 participants also suggested that Ginkgo biloba was a safe and effective treatment for drug-induced parkinsonism, another movement disorder caused by medication use.

If treatment does not fully reverse your TD, you may still be able to improve your symptoms with targeted management strategies.

Physical therapy

Physical therapy is used in many types of movement disorders, including TD. It can help improve your coordination, balance, and strength so that your TD symptoms are less disruptive.

Physical therapy can also help reduce the stiffness and muscle rigidity that can come from uncontrollable movements.

Botulinum toxin (Botox) injections

Botox injections are used in both medical and cosmetic procedures. The botulinum neurotoxin can paralyze or impair muscle function by blocking nerve signals.

A 2021 review notes that Botox injections can help manage many neurologic movement disorders, including TD. But individual results can vary depending on the severity and location of your symptoms.

Repeat injections are often necessary to maintain results.

Lifestyle strategies

Taking care of your overall health and well-being can lessen the impact that TD symptoms have on your life. For example, regular exercise can help improve movement symptoms that affect your balance, flexibility, and gait.

Lifestyle interventions can improve your general wellness and may reduce the effects of underlying conditions that require long-term medication use.

General recommendations include:

  • eating a well-balanced diet
  • getting plenty of good quality sleep whenever possible
  • avoiding smoking
  • avoiding substance use

Treatment for chronic conditions

TD is caused by long-term use of certain medications. By staying in contact with your doctor and keeping up with regular evaluations, you can ensure that your treatment plan is up to date and evolving with your needs.

New therapies are always emerging. The more methods you can find to manage chronic medical conditions, the less you may need long-term use of medications that increase the risk of TD.

Tardive dyskinesia (TD) is a neurological condition and a drug-induced movement disorder. It happens when long-term use of dopamine receptor-blocking medications changes chemical signaling in your brain, resulting in motor symptoms.

There’s no cure for TD, but treatment may be able to reverse the symptoms in some people. Physical therapy, Botox injections, and healthy lifestyle strategies can help with symptom management.

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