Learn About Tardive Dyskinesia

What is the definition of Tardive Dyskinesia?

Tardive dyskinesia (TD) is a disorder that involves involuntary movements. Tardive means delayed and dyskinesia means abnormal movement.

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What are the alternative names for Tardive Dyskinesia?

TD; Tardive syndrome; Orofacial dyskinesia; Involuntary movement - tardive dyskinesia; Antipsychotic drugs - tardive dyskinesia; Neuroleptic drugs - tardive dyskinesia; Schizophrenia - tardive dyskinesia

What are the causes of Tardive Dyskinesia?

TD is a serious side effect that occurs when you take medicines called neuroleptics. These drugs are also called antipsychotics or major tranquilizers. They are used to treat mental problems.

TD often occurs when you take the drug for many months or years. In some cases, it occurs after you take them for as little as 6 weeks.

Medicines that most commonly cause this disorder are older antipsychotics, including:

  • Chlorpromazine
  • Fluphenazine
  • Haloperidol
  • Perphenazine
  • Prochlorperazine
  • Thioridazine
  • Trifluoperazine

Newer antipsychotics seem less likely to cause TD, but they are not entirely without risk.

Other drugs that can cause TD include:

  • Metoclopramide (treats stomach problem called gastroparesis)
  • Antidepressant medicines such as amitriptyline, fluoxetine, phenelzine, sertraline, trazodone
  • Anti-Parkinson medicines such as levodopa
  • Antiseizure medicines such as phenobarbital and phenytoin
What are the symptoms of Tardive Dyskinesia?

Symptoms of TD include uncontrollable movements of the face and body such as:

  • Facial grimacing (commonly involving lower facial muscles)
  • Finger movement (piano playing movements)
  • Rocking or thrusting of the pelvis (duck-like gait)
  • Jaw swinging
  • Repetitive chewing
  • Rapid eye blinking
  • Tongue thrusting
  • Restlessness
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What are the current treatments for Tardive Dyskinesia?

When TD is diagnosed, the health care provider will either have you stop the medicine slowly or switch to another one.

If TD is mild or moderate, various medicines may be tried. A dopamine-depleting medicine, tetrabenazine is most effective treatment for TD. Valbenazine is an alternative. Your provider can tell you more about these.

If TD is very severe, a procedure called deep brain stimulation DBS may be tried. DBS uses a device called a neurostimulator to deliver electrical signals to the areas of the brain that control movement.

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What is the outlook (prognosis) for Tardive Dyskinesia?

If diagnosed early, TD may be reversed by stopping the medicine that caused the symptoms. Even if the medicine is stopped, the involuntary movements may become permanent, and in some cases, may become worse.

Central nervous system and peripheral nervous system
What are the latest Tardive Dyskinesia Clinical Trials?
A Randomized, Double-blinded, Placebo-controlled, Dose-escalation Phase I Study to Evaluate the Safety, Tolerability and Pharmacokinetic of LPM3770164 Sustained-release Tablets in Healthy Subjects
Summary: This is a single-center, randomized, double-blinded, placebo-controlled, dose escalation trial to evaluate the safety, tolerability and pharmacokinetic of LPM3770164 sustained-release tablets orally administered in healthy subjects under fasting state, providing the rationale information for subsequent clinical trials.
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A Feasibility Clinical Trial of the Magnetic Resonance Guided Focused Ultrasound (MRgFUS) for the Management of Treatment-Refractory Movement Disorders
Summary: The proposed study is to evaluate the effectiveness of ExAblate Transcranial MRgFUS as a tool for creating a unilateral lesion in the Vim thalamus or the globus pallidus (GPi) in patients with treatment-refractory symptoms of movement disorders.
What are the Latest Advances for Tardive Dyskinesia?
Effects of Long-Term Deutetrabenazine Treatment in Patients with Tardive Dyskinesia and Underlying Psychiatric or Mood Disorders.
Summary: Effects of Long-Term Deutetrabenazine Treatment in Patients with Tardive Dyskinesia and Underlying Psychiatric or Mood Disorders.
Long-Term Effects of Once-Daily Valbenazine in Older and Younger Adults with Tardive Dyskinesia.
Summary: Long-Term Effects of Once-Daily Valbenazine in Older and Younger Adults with Tardive Dyskinesia.
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Long-Term Efficacy and Safety of Deutetrabenazine in Patients with Tardive Dyskinesia by Concomitant Dopamine-Receptor Antagonist Use.
Summary: Long-Term Efficacy and Safety of Deutetrabenazine in Patients with Tardive Dyskinesia by Concomitant Dopamine-Receptor Antagonist Use.
Who are the sources who wrote this article ?

Published Date: April 25, 2022
Published By: Joseph V. Campellone, MD, Department of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Aronson JK. Neuroleptic drugs. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier B.V.; 2016:53-119.

Freudenreich O, Flaherty AW. Patients with abnormal movements. In: Stern TA, Freudenreich O, Smith FA, Fricchione GL, Rosenbaum JF, eds. Massachusetts General Hospital Handbook of General Hospital Psychiatry. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 21.

Freudenreich O, Goff DC, Henderson DC. Antipsychotic drugs. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 42.

Okun MS, Lang AE. Other movement disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 382.

ul Haq I, Liebenow B, Okun MS. Clinical overview of movement disorders. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 105.