Tips for Eating and Drinking with Tardive Dyskinesia

Tardive dyskinesia (TD) can cause issues with eating and swallowing, which can lead to further complications. Practices like adjusting medication as needed, meeting with a speech pathologist, and making dietary changes can help a person eat and drink safely.

Tardive dyskinesia (TD) is a movement disorder that’s caused by certain medications. TD causes uncontrollable movements, and in some cases, it can affect the muscles you use for swallowing. When TD involves these muscles, eating and drinking may become difficult and even dangerous. Swallowing problems can also lead to difficulty eating a balanced diet and may affect a person’s quality of life.

This article offers useful tips to help people and caregivers manage TD-related swallowing issues.  

TD often affects the head and neck muscles, which manage movements of the lips, tongue, jaw, and throat. Together, these muscles help you swallow. This involves four steps:

• chewing food and shaping it into a ball 
• moving the food to the back of the mouth 
• opening the throat and moving the food into the esophagus
• moving the food down the esophagus into the stomach

If TD affects muscles of the lips, tongue, jaw, or throat, these steps may not happen as smoothly as they should. This can lead to any of the following problems:

In some cases, trouble swallowing can lead to a condition called aspiration pneumonia. This is a bacterial infection from food or liquids getting into the lungs instead of going to the stomach. It happens when your muscles do not close off your windpipe when you swallow.

If you have any of the symptoms listed above, tell your doctor. They can determine whether your symptoms are a result of TD or not. The sooner you talk with your doctor, the better your outcome may be.

If you do have TD, there are several things you can do to improve your swallowing as well as make eating and drinking easier.

Because medications cause TD, it may help to adjust the medications you take. Talk with your doctor about any medications that could be causing your symptoms. They may suggest adjusting the dose or switching you to another type of medication.

If they do not suggest a change, your doctor might prescribe other medication to help manage symptoms. Two FDA-approved drugs are currently available that can treat tardive dyskinesia, deutetrabenazine (Austedo) and valbenazine (Ingrezza).

Your doctor can help you understand whether either of these medications is right for you.

Speech-language pathologists have special training in helping people with speech and swallowing problems. They work with people to improve swallowing using exercises to change how your swallowing muscles function. They can also offer techniques that help people work around the difficulties.

For some people, the texture or temperature of foods can affect how they swallow. You may need to thicken foods and beverages or change them in other ways to make swallowing easier. Your speech-language pathologist can complete an evaluation and suggest dietary changes. 

However, changing how you eat can possibly cause other issues, such as a dietary plan that’s low in nutrition and hydration. Changing the texture of food or beverages could also lead to aspiration pneumonia in some people. So it is important to work with a speech-language pathologist to reduce these risks.

Safe eating practices can vary depending on the specific swallowing issues you have. A speech-language pathologist can help you understand the best techniques for you. This may include:

• changing the size of each swallow
• using cues to help maintain the best rate or pace of eating
• using your posture to make swallowing easier

TD can affect your mental health and quality of life. If this is the case, it’s important to seek emotional and psychological support while you treat your TD.

Your doctor may be able to refer you to a mental health professional. A therapist or counselor can give you coping techniques and relaxation exercises. Stress can make swallowing problems worse because it increases muscle tension. By managing stress, your muscles have a better chance of relaxing and easing swallowing.

Swallowing problems can be a complication of TD for some people. It’s important to tell your doctor as soon as possible if you have swallowing problems as a result of TD. They may need to adjust your medication. They may also suggest working with a speech-language pathologist. These professionals can help manage swallowing problems and prevent complications.