Tardive Dyskinesia (TD)

What is Tardive Dyskinesia?

Tardive dyskinesia (TD) is a neurological disorder characterized by involuntary movements (dyskinesias) of the jaw, lips, and tongue. It is most frequently caused by long-term use of certain medications used to treat psychiatric disorders. These include antipsychotic medications used to treat schizophrenia, bipolar disorder, and depression.

TD can be mild or severe, and the severity can vary over time. Symptoms usually start gradually, but may progress quickly. Symptoms include involuntary movements of the face, lips, tongue, arms, legs, and trunk. People with TD may have difficulty controlling their emotions and have difficulty speaking, eating, and performing other activities.

Symptoms

Symptoms of TD include:

• Involuntary, repetitive movements of the face, lips, and tongue, such as grimacing, sticking out the tongue, smacking lips, and other rapid movements.
• Involuntary movements of the arms, legs, and trunk, such as jerking, twisting, writhing, or rolling the trunk.
• Difficulty controlling emotions.
• Problems with speech, including slurred speech or stuttering.
• Difficulty eating, due to involuntary movements of the mouth and tongue.

Causes

TD is most commonly caused by antipsychotic medications for the treatment of psychiatric disorders. These medications are dopamine receptor inhibitors, and block the signals sent from dopamine receptors to the brain. This causes an increase in dopamine activity in the brain, which can lead to TD.

Other medications that can cause TD include metoclopramide (Reglan), reserpine, and tetrabenazine (Xenazine). Additionally, TD can be caused by long-term use of certain drugs that are abused, such as cocaine, marijuana, and methamphetamine.

Treatment

TD is not curable, but symptoms can be managed with lifestyle changes, medications, and therapies. Medications that can help manage TD include vitamin supplements such as niacin and B6, as well as medications to reduce dopamine levels in the brain, such as clozapine (Clozaril), olanzapine (Zyprexa), and quetiapine (Seroquel).

Physical therapy and speech therapy can help some people with TD regain control over their movements and speech. Additional treatments may include biofeedback, relaxation techniques, and massage therapy.