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Tardive dyskinesia is a movement disorder that manifests as involuntary, repetitive movements, primarily affecting the face, but can also impact other parts of the body. Over 600,000 people in the United States are affected by tardive dyskinesia. The onset of tardive dyskinesia can be gradual and often occurs after prolonged medication use, making it a challenging side effect to predict and manage.

Understanding tardive dyskinesia is crucial for individuals undergoing treatment for mental health and neurological conditions, as well as for their healthcare providers. Awareness of the potential for tardive dyskinesia and its implications is the first step in mitigating its impact on an individual’s quality of life. This article aims to shed light on tardive dyskinesia, from its symptoms and causes to diagnosis, treatment, and management, offering hope and support to those navigating this condition.

What is Tardive Dyskinesia?

Tardive dyskinesia is a condition characterized by involuntary, repetitive movements. These movements often involve the face, but can also extend to the limbs and torso, manifesting as jerky or twisting motions. Tardive dyskinesia is primarily associated with the prolonged use of certain medications commonly prescribed to those struggling with mental health disorders. 

The development of tardive dyskinesia is particularly insidious due to its delayed onset; symptoms can appear months, or even years, after the initiation of medication. This delay complicates the diagnosis and management of tardive dyskinesia, as the connection between symptom onset and medication use may not be immediately apparent.

Symptoms of Tardive Dyskinesia

The symptoms of tardive dyskinesia can vary significantly in their presentation and severity. The most recognizable symptoms are those affecting the facial and oral regions:

  • Facial Movements: Grimacing, blinking, and other facial movements that are involuntary and repetitive.
  • Oral Movements: Lip-smacking, puckering, and pursing, as well as tongue protrusion and movements within the mouth that are uncontrollable.
  • Jaw Movements: Jaw swinging, clenching, and chewing motions without food.

Beyond the face, tardive dyskinesia can also manifest in other parts of the body:

  • Finger Movements: Movements resembling tapping motions that are continuous and involuntary.
  • Limb Movements: Jerking, twisting, or flailing movements of the arms and legs.
  • Trunk Movements: Rocking, thrusting, or twisting motions of the torso.

These symptoms can fluctuate in intensity and may be exacerbated by stress or fatigue. Sometimes, the movements subside during sleep, only to reappear upon waking. The unpredictability and visibility of these symptoms contribute significantly to the distress and social withdrawal experienced by those with tardive dyskinesia, making it imperative to approach this condition with a comprehensive and empathetic treatment strategy.

Causes and Risk Factors

The primary cause of tardive dyskinesia is prolonged exposure to certain medications, particularly those that block dopamine receptors in the brain. These medications are commonly used to treat mental health disorders and include both first-generation (typical) and second-generation (atypical) antipsychotics.

Several risk factors increase the likelihood of developing tardive dyskinesia:

  • Long-term Medication Use: The risk of tardive dyskinesia increases with the duration of medication use, particularly with antipsychotics. The condition is more common in individuals who have been on these medications for months or years.
  • Age: Older adults are at a higher risk for developing tardive dyskinesia, possibly due to cumulative exposure to medications over time and age-related changes in brain chemistry.
  • Gender: Women, especially postmenopausal women, are at a higher risk for tardive dyskinesia, although the reasons for this gender disparity are not fully understood.
  • Underlying Health Conditions: Certain conditions, such as diabetes and mood disorders, may increase the susceptibility to tardive dyskinesia. 

Understanding these risk factors is crucial for both patients and healthcare providers to make informed decisions about the use of medications and to monitor for early signs of tardive dyskinesia.

Tardive Dyskinesia Diagnosis

Diagnosing tardive dyskinesia involves a careful evaluation of symptoms, medication history, and the exclusion of other conditions that could cause similar movement disorders. There is no specific test for tardive dyskinesia; instead, the diagnosis is primarily clinical, based on observation and patient history.

Healthcare providers will typically:

  • Review Medication History: A detailed account of current and past medications is essential, with particular attention to those known to be associated with tardive dyskinesia.
  • Conduct a Physical Examination: This includes observing the involuntary movements and assessing their impact on daily functioning.
  • Use Diagnostic Scales: Tools like the Abnormal Involuntary Movement Scale (AIMS) are often used to systematically assess the presence and severity of tardive dyskinesia symptoms.
  • Rule Out Other Conditions: Conditions such as Parkinson’s disease, Huntington’s disease, and other neurologic disorders can cause similar symptoms and must be excluded. This may involve neurological assessments and, in some cases, imaging studies.

Treatment and Management

Managing tardive dyskinesia requires a multifaceted approach that includes medication review and adjustments, as well as various therapeutic interventions. The goal is to alleviate symptoms and improve quality of life. 

Medication Review and Adjustments

Regular medical reviews are crucial for individuals at risk of or diagnosed with tardive dyskinesia. These reviews allow healthcare providers to monitor symptoms, assess the effectiveness of current treatments, and make necessary adjustments. In some cases, this may involve:

  • Reducing the Dosage: Lowering the dose of the causative medication can sometimes alleviate tardive dyskinesia symptoms without compromising the treatment of the underlying condition.
  • Switching Medications: If possible, switching to a different medication with a lower risk of causing tardive dyskinesia may be recommended. This is often feasible with antipsychotic medications, where a change from first-generation to certain second-generation antipsychotics can reduce tardive dyskinesia risk.
  • Medication Discontinuation: In some cases, it may be appropriate to gradually discontinue the causative medication, if the underlying condition allows. This decision must be made carefully to avoid exacerbating the primary disorder.

Therapeutic Interventions

In addition to medication adjustments, specific treatments aimed at managing tardive dyskinesia symptoms may be employed:

  • VMAT2 Inhibitors: Medications such as Deutetrabenazine and Valbenazine have been approved specifically for the treatment of tardive dyskinesia. These drugs work by regulating dopamine levels in the brain and can significantly reduce involuntary movements.
  • Supportive Therapies: Physical therapy can help manage the physical aspects of tardive dyskinesia, such as improving gait and balance. Occupational therapy may assist in adapting daily activities to cope with tardive dyskinesia symptoms. Stress management techniques, including mindfulness and relaxation exercises, can also be beneficial, as stress can exacerbate tardive dyskinesia symptoms.

Getting Help With Tardive Dyskinesia 

Tardive dyskinesia is a complex condition with significant implications for those affected. While the condition can be challenging, advancements in treatment and a comprehensive care approach offer hope for managing symptoms and maintaining quality of life.

At The Phoenix Recovery Center, we understand the intricacies of managing mental health conditions and their associated challenges, including tardive dyskinesia. Our dedicated team is committed to providing personalized care that encompasses medical treatment, therapeutic interventions, and unwavering support.

If you or a loved one are navigating the complexities of mental health treatment and experiencing symptoms of tardive dyskinesia, know that you are not alone. Reach out to The Phoenix Recovery Center for comprehensive care and support designed to empower individuals on their journey to recovery and wellness. Together, we can face the challenges of tardive dyskinesia and work towards a brighter, more hopeful future. Call the Phoenix Recovery Center today at ​​(801) 438-3185.

The Phoenix Recovery Center
489 W. South Jordan Pkwy
Suite 400
South Jordan, UT