Tardive dyskinesia (TD) is a movement disorder. It’s a side effect of taking neuroleptic drugs. Treatment is focused on stopping the recurrence or persistence of symptoms.

Tardive dyskinesia (TD) is a side effect of taking neuroleptics, which are a type of antipsychotic drugs. These medications are typically prescribed for psychiatric and neurological disorders, and sometimes for gastrointestinal (GI) disorders.

Some studies suggest that between 20–50% of people taking neuroleptics will develop TD over the course of their treatment.

The condition can be permanent. But, gradually discontinuing the medication that’s causing it or getting treatment after symptoms begin may prevent the condition’s progression or even reverse it.

Keep reading to learn more about the symptoms, causes, and treatment options for TD.

Symptoms of TD typically involve uncontrollable, repetitive, and writhing movements. These could affect your face, torso, and limbs.

For example, you may experience some of the following movements:

  • blinking frequently
  • smacking or puckering your lips
  • sticking out your tongue
  • puffing out your cheeks
  • toe tapping
  • swaying, side-to-side movement of the torso
  • thrusting of the pelvis

Whether fast or slow, the uncontrollable movements associated with TD may interfere with your ability to work, perform day-to-day tasks, and stay active.

If you begin to experience symptoms of TD and you’re taking neuroleptic medications, speak with a doctor right away. They may decide to reduce your dose or switch to a different drug to try and stop the symptoms.

Your symptoms of TD may improve after you stop taking the medication, while for others their symptoms may remain. It’s unclear why some people improve and others do not.

TD is caused by taking dopamine receptor antagonist medications. These work by blocking dopamine receptors in your brain. However, the medications may lead to this side effect.

Some medications associated with TD include:

  • first-generation antipsychotics, such as chlorpromazine (Thorazine), fluphenazine (Prolixin, Permitil), perphenazine, prochlorperazine (Compro), haloperidol (Haldol), thioridazine, and trifluoperazine
  • second-generation antipsychotics, such as metoclopramide (Reglan, Metozolv ODT) and aripiprazole (Abilify)
  • antidepressant drugs, such as trazodone, amitriptyline, and fluoxetine
  • antiseizure drugs, such as phenytoin and phenobarbital

Not everyone who takes these drugs will develop TD. However, your risk of developing TD increases the longer you take them.

At least 20% of people taking an older version of these drugs, known as first-generation antipsychotics, will develop TD. This number is higher compared to people using newer medications, known as second-generation antipsychotics.

Symptoms of TD may appear 1–6 months after you begin taking a certain medication. In some cases, this may even take years.

A doctor will first conduct a physical and medical history examination. They’ll want to see if any medications are causing your symptoms.

Then, they’ll assess your symptoms using the Abnormal Involuntary Movement Scale (AIMS). This is a five-point measurement that helps doctors measure:

  • the severity of your movements
  • whether you’re aware of the movements
  • whether you’re in distress as a result of them

If symptoms appear after you’ve stopped taking a medication, the doctor may not associate the drug with your symptoms right away. However, if you’re still using the medication, a diagnosis may be a bit easier.

The doctor may also order blood tests and brain scans to rule out other conditions that may cause atypical movements. These may include:

The treatment plan that’s right for you will depend on several factors, such as:

  • how severe your TD symptoms are
  • how long you’ve been taking a medication
  • your age
  • what medication you’re taking
  • associated conditions, such as other neurological disorders

Prevention

The first-line treatment is to address the medication that’s causing your symptoms of TD. This may involve:

  • stopping to take the specific medication
  • reducing your dosage
  • taking a different medication that’s less likely to cause TD, such as clozapine

Seeing a doctor every 3 months for an examination of TD symptoms is recommended if you’re taking antipsychotic medications.

Medication

In 2017, the U.S. Food and Drug Administration (FDA) approved the two drugs valbenazine (Ingrezza) and deutetrabenazine (Austedo) to help treat TD.

These medications can affect some of the chemicals that resemble dopamine. This may play a role in how they affect symptoms, but researchers don’t fully understand exactly how they help control TD.

The drug clonazepam may also be prescribed short-term to help with muscle rigidity, according to the National Alliance on Mental Illness (NAMI).

Natural remedies

Some natural remedies may also help reduce TD symptoms.

For example, a 2016 meta-analysis found that ginkgo biloba extract may help reduce the symptoms of TD in people with schizophrenia. A 2017 review also found that melatonin may have similar benefits.

However, the authors of a 2019 review note there isn’t enough research to support the usage of these additional treatments for TD.

If you’re experiencing severe symptoms of TD, deep brain stimulation may also help relieve symptoms.

Speak with a doctor before trying a natural remedy.

What is an example of tardive dyskinesia?

Some examples of TD include:

  • blinking frequently
  • smacking or puckering your lips
  • sticking out your tongue
  • puffing out your cheeks

What medications cause tardive dyskinesia?

The medications that most commonly cause TD are neuroleptics, also known as antipsychotics. Other medications that may cause TD include:

  • antidepressants
  • anticholinergics
  • antiemetics
  • anticonvulsants
  • antihistamines
  • decongestants
  • antimalarials
  • anxiolytics

Some illicit stimulant drugs may also cause TD, including amphetamines, methylphenidate, and cocaine.

TD is a movement disorder that causes involuntary movements.

Early diagnosis and treatment can help decrease your symptoms and prevent any complications, such as long-term TD. However, it’s important to note that symptoms of TD can be permanent. For some people, they may get worse over time, even after they stop taking the medication.

The best way to prevent persistent TD is to be aware of your body and any unusual symptoms you experience.

Speak with a doctor if anything unfamiliar occurs. Together, you can decide how to stop the movements and still treat underlying issues.