Tardive dyskinesia (TD) causes uncontrollable movements of your face and body. These movements can happen after you take certain antipsychotic medications to treat a mental health condition such as schizophrenia, bipolar disorder, or depression.
Antipsychotic medications change the actions of the chemical dopamine in parts of your brain that control movement. You’re more likely to develop TD if you take an older, first-generation antipsychotic medication and you’re on a high dose. About 1 in 5 people who are on one of these drugs develop TD.
Seeing your face and body move in ways you can’t control can be frustrating. However, your doctor can help you find the right treatment to manage TD symptoms and improve your quality of life.
Who might develop tardive dyskinesia?
You may be more likely to develop TD if you:
Antipsychotic drugs are the most common cause of tardive dyskinesia. Rarely, anti-nausea medicines, antidepressants, and the mood stabilizer lithium can also cause this condition.
Most common symptoms of tardive dyskinesia
TD is known for causing uncontrollable movements of the face, neck, body, arms, and legs. These movements may be slow and writhing (athetosis) or quick and jerky (chorea). Sometimes, the movements are uncomfortable or painful over time.
These are 14 possible symptoms of TD:
- blinking your eyes quickly
- frowning or grimacing
- making sucking or chewing movements with your mouth
- puffing out your cheeks
- smacking your lips
- sticking out your tongue
- bobbing your head
- twisting your neck
- wiggling your fingers like you’re playing the piano
- tapping your hands or feet
- fidgeting, swaying, or wiggling your body
- jerking or twisting your arms and legs
- thrusting or rocking your hips
- walking like a duck
If you notice any of these symptoms, tell the doctor who prescribed the antipsychotic medication. They might refer you to a neurologist for tests.
Watching for tardive dyskinesia
TD can start 1 to 6 months or later after you begin an antipsychotic medication. The movements often begin slowly and may be so subtle at first that you don’t notice them.
You may have more movements when stressed and less while asleep. In time, the symptoms could become more noticeable and interfere with your daily life.
Questions to ask your doctor
If you have to be on an antipsychotic drug for a long time, your doctor may monitor you for TD. Diagnosing these movements early could lead to a better outcome. To get a correct diagnosis, it helps for your doctor to know your symptoms and all the medicines you’ve taken.
These are some questions to ask your doctor about TD during your appointment:
- What symptoms should I watch for when I take an antipsychotic medicine?
- If I have TD, can I safely stop taking my medicine or reduce the dose?
- Can you switch me to another drug to manage my mental health?
- What are the treatments for TD?
You might also ask how often you should do follow-up visits while you take an antipsychotic medication and what to do if you have these uncontrollable movements.
Treatments for tardive dyskinesia
The first step in treating TD might be to reduce the dose or stop taking the medication that caused it. Your mental health professional will weigh the severity of your TD symptoms against the risks to your mental health if you were to stop taking the drug.
In some cases, people who stop the medication that caused their TD will see an improvement in symptoms.
If TD symptoms don’t improve, your doctor might prescribe one of these treatments:
- Valbenazine (Ingrezza) or deutetrabenazine (Austedo): These medications are approved to treat movement disorders.
- Deep brain stimulation: A pacemaker-like device placed under the skin of your chest sends impulses to your brain to control the movements.
- Botulinum toxin: Injections of Botox help stop the muscle movements.
The sooner you get help for TD, the better the chance of slowing or stopping the movements. A mental health professional and neurologist can help you find the proper treatment.
Contact the National Organization for Tardive Dyskinesia if you need more support or advice about TD.