Tardive dyskinesia (TD) is a movement disorder that develops from taking dopamine receptor-blocking medications, such as certain first-generation (“typical”) antipsychotics. It causes uncontrolled movements in the body.
There are options to manage this condition, and sometimes it can be cured completely. A doctor may recommend switching medications to help slow the progression of TD.
Other options include medications designed to target TD, certain supplements, or lifestyle changes.
Since TD is linked with certain prescription medications, such as first-generation antipsychotics, some doctors may recommend reducing the dosage or switching to a second-generation version.
For example, if you’re taking a first-generation antipsychotic for the treatment of schizophrenia, a doctor may prescribe a second-generation version that’s less likely to cause TD, such as risperidone or quetiapine.
However, for some people, symptoms of TD continue even after discontinuing the use of a first-generation antipsychotic. Part of the problem is that TD develops over a long period of time, usually several years. Stopping a possible medication linked with TD doesn’t always reverse the onset of this movement disorder.
There’s also some evidence that atypical dopamine receptor-blocking drugs could further aggravate TD symptoms. If a doctor does switch your primary medication from a typical to a different antipsychotic, they’ll want to regularly screen you for TD.
Medication that’s been approved for the treatment of TD can help relieve symptoms without stopping your primary medication. These include deutetrabenazine (Austedo) and valbenazine (Ingrezza).
While these treatments don’t cure TD, they may help stop its progression while reducing symptoms. Both medications work by inhibiting vesicular monoamine transporter type 2 (VMAT2) proteins in the brain, which can help reduce excess dopamine levels contributing to TD.
Deutetrabenazine
Sold under the brand name Austedo, this medication is used to help treat TD as well as other movement disorders, such as Huntington’s chorea. The Food and Drug Administration (FDA) approved it for TD in 2017.
When used for TD, a doctor may prescribe a higher dose to start and gradually decrease it to a maintenance dose.
While this medication hasn’t been shown to completely get rid of symptoms, such as uncontrolled movements, there’s a chance that these will at least improve. In fact, one
Valbenazine
Valbenazine (Ingrezza), is primarily prescribed for TD treatment. The FDA also approved this medication for TD in 2017. Like deutetrabenazine, valbenazine is prescribed in higher doses at first.
Clinical studies have shown that valbenazine may improve TD symptoms in some people, though they’re likely to come back or worsen once you stop taking this medication.
Deep brain stimulation (DBS) is a type of surgery that’s typically used to treat neurological disorders with the help of an implanted device in your brain that helps control body movements. It may also help treat symptoms of dystonia, such as involuntary muscle movements.
While DBS isn’t considered a first-line treatment for TD, it may be a safe and effective option for severe TD that doesn’t respond to medications.
Botulinum toxin type A (Botox) injections are perhaps best known as cosmetic treatments. The way this medication helps block targeted nerves and muscles may be helpful for a variety of other conditions, including migraine, dystonia, and overactive bladder.
Botox injections are being studied for TD due to their clinically proven effects on other movement disorders.
Aside from medications, you might consider talking with a doctor to see if taking certain supplements might help your TD symptoms. While more long-term research is needed regarding safety and efficacy, the following supplements currently show the most promise:
- Vitamin E: This fat-soluble vitamin is perhaps the most widely studied supplement for TD. While vitamin E can’t prevent TD,
research suggests that it may help stop symptoms from worsening.One 2018 review reports that vitamin E may be most effective within 5 years of TD onset. - Vitamin B6: According to a
2020 meta-analysis , this B vitamin may help treat TD symptoms, especially when used alongside vitamin E and VMAT2 inhibitors. - Ginkgo biloba: This herbal supplement has antioxidant and anti-inflammatory components that may help alleviate TD symptoms when combined with medications, though more research is needed.
While TD is caused by taking certain medications over a long period of time, certain lifestyle changes may reduce your risk of developing this movement disorder. These include quitting smoking and avoiding substance usage.
Additionally, unmanaged diabetes may increase your risk of developing TD while taking dopamine receptor blockers. Talk with a doctor about ways you can help manage your blood sugar levels, including diabetes medications, a balanced diet, and regular exercise.
TD is a complex condition that can eventually become debilitating. Early diagnosis is important so a doctor can help you treat and manage this movement disorder.
Just as TD isn’t caused by one specific medication, there’s no one-size-fits-all treatment.
Don’t stop taking any prescribed medications without a doctor’s approval. It’s important to assess your options with a doctor and to try another method if one doesn’t work for you.