Table of ContentsView AllTable of ContentsCausesSymptomsWhat Is My Risk?Odds of ReversalTD MedicationsPreventionNext in Tardive Dyskinesia GuideWhat Is Tardive Dyskinesia?
Table of ContentsView All
View All
Table of Contents
Causes
Symptoms
What Is My Risk?
Odds of Reversal
TD Medications
Prevention
Next in Tardive Dyskinesia Guide
Tardive dyskinesia(TD) is a drug-induced disorder that causes involuntary movements like grimacing and lip-smacking. It may or may not be reversible based on the duration or degree of exposure to antipsychotic drugs and other associated medications.
In the past, there was little that one could do to treat this often distressing condition, and the drugs commonly used for treatment (likebenzodiazepinesorcalcium channel blockers) proved largely ineffective.
Since 2017, however, a growing range of medications has proven effective in minimizing or eliminating symptoms of TD in some people. Moreover, a greater understanding of the causes of TD has altered prescribing practices to better prevent symptoms from occurring in the first place.
What Causes Tardive Dyskinesia?
Tardive dyskinesiawas first noted during the 1950s in people exposed to first-generation antipsychotic drugs, known today as typical antipsychotics.
At the same time, overexposure to neuroleptics can cause changes in parts of the brain that influence voluntary movements, most especially thenigrostriatal pathway, Problems with this part of the brain are known to trigger motor dysfunction in people withParkinson’s diseaseandHuntington’s disease.
Typical antipsychotic drugs linked to a high risk of TD include:
Newer, second-generation antipsychotics—calledatypical antipsychotics—are less likely to cause TD but still pose some risk. This includes drugs like Clozaril (clozapine), Zyprexa (olanzapine), Risperdal (risperidone), Invega (paliperidone), Seroquel (quetiapine), Abilify (aripiprazole), Latuda (lurasidone), and Geodon (ziprasidone).
In recent decades, a growing list of neuroleptic drugs or drugs with neuroleptic properties have also been linked to the development of TD, including:
What Happens When You Get Tardive Dyskinesia?
Common symptoms of TD include:
If you are prescribed antipsychotics or other drugs associated with TD, it is important to be on the lookout forearly signsso that you can stop treatment before the movements become irreversible.
What Is My Risk of Getting Tardive Dyskinesia?
This is particularly true with typical antipsychotics which have their place in the treatment of schizophrenia and condtions likebipolar disorder,depression, andAlzheimer’s disease. With this class of drugs, symptoms can appear within three months, although some people may experience them far earlier or later than this.
In total, between 20% and 50% of people on antipsychotics, both typical and atypical, will develop TD, according to a 2018 study from Louisiana State University.
Beyond these medication factors, other things can increase a person’s risk of TD, including:
With that said, scientists are still not fully sure why some people on the same drug treatment will get TD while others don’t.
Can Tardive Dyskinesia Be Reversed?
Generally speaking, the sooner you stop a medicine after TD symptoms first appear, the greater your chance of reversing the condition.
The problem is that TD can often go unnoticed or be discounted as an incidental “tic” for months or years before action is taken. This is especially true if the patient has no idea that TD is a possible side effect of a chronic drug.
Even if action is taken, the odds of reversibility are relatively low.
Most studies suggest that less than one in four people with TD will experience a complete resolution of symptoms after the discontinuation of treatment. Of those who do, it may take up to three years for symptoms to fully reverse.
Medications Used to Treat Tardive Dyskinesia
In 2017, two FDA-approved drugs proved effective in partially or fully reversing symptoms of TD and today are offered as first-line therapies:
How Effective Are Ingrezza and Austedo?A 2018 review of studies published inInnovations in Clinical Neurosciencereported that 49% of people given a daily 24-milligram (mg) dose of Austedo reported feeling “much improved” or “very much improved” after four weeks. Similarly, 61% of people given 50 to 100 mg of Ingrezza per day reported feeling “much improved” or “very much improved” after six weeks.
How Effective Are Ingrezza and Austedo?
A 2018 review of studies published inInnovations in Clinical Neurosciencereported that 49% of people given a daily 24-milligram (mg) dose of Austedo reported feeling “much improved” or “very much improved” after four weeks. Similarly, 61% of people given 50 to 100 mg of Ingrezza per day reported feeling “much improved” or “very much improved” after six weeks.
Can Tardive Dyskinesia Be Prevented?
Because scientists are unable to predict who may or may not develop TD, healthcare providers today will prescribe the lowest effective dose of a neuroleptic drug for the shortest period to limit the risk.
With that said, the provider will need to weigh the benefits of an antipsychotic drug against the risks, particularly in people with schizophrenia. In such cases, an atypical antipsychotic may be preferred over a typical antipsychotic given its lower risk of TD.
A few studies suggest that taking a dailyvitamin E supplementwith an antipsychotic may reduce the risk of TD or potentially slow the progression if it occurs. On the other hand, there is no evidence that vitamin E can reverse TD once it develops.
Summary
Tardive dyskinesia is a movement disorder that results from the use of antipsychotic drugs and other medications. The condition is often permanent, but, in some cases, can be reversed with FDA-approved medications known as Ingrezza (valbenazine) and Austedo (deutetrabenazine).
The risk of TD can also be reduced if antipsychotics are prescribed at the lowest possible dose for the shortest period of time.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cornett EM, Novitch M, Kaye AD, Kata V, Kaye AM.Medication-induced tardive dyskinesia: a review and update.Ochsner J.2017 Summer;17(2):162–174.Caroff SN, Ungvari GS, Owens DGC.Historical perspectives on tardive dyskinesia.J Neurol Sci.2018 Jun 15:389:4-9. doi:10.1016/j.jns.2018.02.015Luo SX, Huang EJ.Dopaminergic neurons and brain reward pathways: from neurogenesis to circuit assembly.Am J Pathol. 2016 Mar;186(3):478–488. doi:10.1016/j.ajpath.2015.09.023MedlinePlus.Tardive dyskinesia.Grinchii D, Dremencov E.Mechanism of action of atypical antipsychotic drugs in mood disorders.Int J Mol Sci.2020; 15;21(24):9532. doi: 10.3390/ijms21249532.National Organization of Rare Disorders.Tardive dyskinesia.Vinuela A, Kang UJ.Reversibility of tardive dyskinesia syndrome.Tremor Other Hyperkinet Mov (NY).2014;4:282. doi:10.7916/D86Q1VXZDebrey SM, Goldsmith DR.Tardive dyskinesia: spotlight on current approaches to treatment.FOC. 2021;19(1):14-23. doi:10.1176/appi.focus.20200038Caroff SN.Recent advances in the pharmacology of tardive dyskinesia.Clin Psychopharmacol Neurosci. 2020;18(4):493-506. doi:10.9758/cpn.2020.18.4.493Touma KTB, Scarff JR.Valbenazine and deutetrabenazine for tardive dyskinesia.Innov Clin Neurosci. 2018 Jun 1;15(5-6):13–16.Soares-Weiser K, Maayan N, Bergman H.Vitamin E for antipsychotic-induced tardive dyskinesia.Cochrane Database System Rev.2018;1(9):CD000209. doi:10.1002/14651858.CD000209.pub3
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cornett EM, Novitch M, Kaye AD, Kata V, Kaye AM.Medication-induced tardive dyskinesia: a review and update.Ochsner J.2017 Summer;17(2):162–174.Caroff SN, Ungvari GS, Owens DGC.Historical perspectives on tardive dyskinesia.J Neurol Sci.2018 Jun 15:389:4-9. doi:10.1016/j.jns.2018.02.015Luo SX, Huang EJ.Dopaminergic neurons and brain reward pathways: from neurogenesis to circuit assembly.Am J Pathol. 2016 Mar;186(3):478–488. doi:10.1016/j.ajpath.2015.09.023MedlinePlus.Tardive dyskinesia.Grinchii D, Dremencov E.Mechanism of action of atypical antipsychotic drugs in mood disorders.Int J Mol Sci.2020; 15;21(24):9532. doi: 10.3390/ijms21249532.National Organization of Rare Disorders.Tardive dyskinesia.Vinuela A, Kang UJ.Reversibility of tardive dyskinesia syndrome.Tremor Other Hyperkinet Mov (NY).2014;4:282. doi:10.7916/D86Q1VXZDebrey SM, Goldsmith DR.Tardive dyskinesia: spotlight on current approaches to treatment.FOC. 2021;19(1):14-23. doi:10.1176/appi.focus.20200038Caroff SN.Recent advances in the pharmacology of tardive dyskinesia.Clin Psychopharmacol Neurosci. 2020;18(4):493-506. doi:10.9758/cpn.2020.18.4.493Touma KTB, Scarff JR.Valbenazine and deutetrabenazine for tardive dyskinesia.Innov Clin Neurosci. 2018 Jun 1;15(5-6):13–16.Soares-Weiser K, Maayan N, Bergman H.Vitamin E for antipsychotic-induced tardive dyskinesia.Cochrane Database System Rev.2018;1(9):CD000209. doi:10.1002/14651858.CD000209.pub3
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cornett EM, Novitch M, Kaye AD, Kata V, Kaye AM.Medication-induced tardive dyskinesia: a review and update.Ochsner J.2017 Summer;17(2):162–174.Caroff SN, Ungvari GS, Owens DGC.Historical perspectives on tardive dyskinesia.J Neurol Sci.2018 Jun 15:389:4-9. doi:10.1016/j.jns.2018.02.015Luo SX, Huang EJ.Dopaminergic neurons and brain reward pathways: from neurogenesis to circuit assembly.Am J Pathol. 2016 Mar;186(3):478–488. doi:10.1016/j.ajpath.2015.09.023MedlinePlus.Tardive dyskinesia.Grinchii D, Dremencov E.Mechanism of action of atypical antipsychotic drugs in mood disorders.Int J Mol Sci.2020; 15;21(24):9532. doi: 10.3390/ijms21249532.National Organization of Rare Disorders.Tardive dyskinesia.Vinuela A, Kang UJ.Reversibility of tardive dyskinesia syndrome.Tremor Other Hyperkinet Mov (NY).2014;4:282. doi:10.7916/D86Q1VXZDebrey SM, Goldsmith DR.Tardive dyskinesia: spotlight on current approaches to treatment.FOC. 2021;19(1):14-23. doi:10.1176/appi.focus.20200038Caroff SN.Recent advances in the pharmacology of tardive dyskinesia.Clin Psychopharmacol Neurosci. 2020;18(4):493-506. doi:10.9758/cpn.2020.18.4.493Touma KTB, Scarff JR.Valbenazine and deutetrabenazine for tardive dyskinesia.Innov Clin Neurosci. 2018 Jun 1;15(5-6):13–16.Soares-Weiser K, Maayan N, Bergman H.Vitamin E for antipsychotic-induced tardive dyskinesia.Cochrane Database System Rev.2018;1(9):CD000209. doi:10.1002/14651858.CD000209.pub3
Cornett EM, Novitch M, Kaye AD, Kata V, Kaye AM.Medication-induced tardive dyskinesia: a review and update.Ochsner J.2017 Summer;17(2):162–174.
Caroff SN, Ungvari GS, Owens DGC.Historical perspectives on tardive dyskinesia.J Neurol Sci.2018 Jun 15:389:4-9. doi:10.1016/j.jns.2018.02.015
Luo SX, Huang EJ.Dopaminergic neurons and brain reward pathways: from neurogenesis to circuit assembly.Am J Pathol. 2016 Mar;186(3):478–488. doi:10.1016/j.ajpath.2015.09.023
MedlinePlus.Tardive dyskinesia.
Grinchii D, Dremencov E.Mechanism of action of atypical antipsychotic drugs in mood disorders.Int J Mol Sci.2020; 15;21(24):9532. doi: 10.3390/ijms21249532.
National Organization of Rare Disorders.Tardive dyskinesia.
Vinuela A, Kang UJ.Reversibility of tardive dyskinesia syndrome.Tremor Other Hyperkinet Mov (NY).2014;4:282. doi:10.7916/D86Q1VXZ
Debrey SM, Goldsmith DR.Tardive dyskinesia: spotlight on current approaches to treatment.FOC. 2021;19(1):14-23. doi:10.1176/appi.focus.20200038
Caroff SN.Recent advances in the pharmacology of tardive dyskinesia.Clin Psychopharmacol Neurosci. 2020;18(4):493-506. doi:10.9758/cpn.2020.18.4.493
Touma KTB, Scarff JR.Valbenazine and deutetrabenazine for tardive dyskinesia.Innov Clin Neurosci. 2018 Jun 1;15(5-6):13–16.
Soares-Weiser K, Maayan N, Bergman H.Vitamin E for antipsychotic-induced tardive dyskinesia.Cochrane Database System Rev.2018;1(9):CD000209. doi:10.1002/14651858.CD000209.pub3
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