Tardive dyskinesia

TD is a serious side effect that may occur when you take medicines called neuroleptics. These medicines are also called antipsychotics or major tranquilizers. They are used to treat mental health issues.

TD often occurs when you take the medicine for many months or years. In some cases, it can occur 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
• Trifluoperazine

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

Other medicines that can cause TD include:

• Metoclopramide (treats stomach problem called gastroparesis)
• Antidepressant medicines such as amitriptyline, fluoxetine, phenelzine, sertraline, trazodone, lithium
• Anti-Parkinson medicines such as levodopa
• Anti-seizure medicines such as phenobarbital and phenytoin

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

When TD is diagnosed, your 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 to treat it. A dopamine-depleting medicine, tetrabenazine is the most effective treatment for TD. Valbenazine and deutetrabenazine are alternatives. Your provider can tell you more about these treatments.

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.

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.

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

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Updated by: Joseph V. Campellone, MD, Professor of Neurology, Cooper-Inspira Neuroscience, Cooper Medical School of Rowan University, 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.