Tardive Dyskinesia

Tardive dyskinesia (TD) is a neurological syndrome that involves involuntary movements.  

Researchers don’t know the exact cause of tardive dyskinesia. However, the main theory is that it can develop due to the use of dopamine receptor-blocking medications. This includes short-term and long-term use of medications, though it is more likely to develop after long-term use. It can also occur after the discontinuation of, a change in, or the reduction in medication.  

Tardive dyskinesia can develop due to exposure to the following medications: 

• Antipsychotic medications 

• Anti-nausea medications 

• Certain antidepressants 

Tardive dyskinesia can cause involuntary movements of the: 

• Facial muscles 

• Tongue 

• Neck 

• Trunk muscles 

• Limbs 

Facial involuntary movements caused by TD may include: 

• Lip-smacking or making sucking motions with your mouth 

• Grimacing or frowning 

• Sticking the tongue out or against the inside of your cheek 

• Chewing movements 

• Puffing of your cheeks 

• Rapid eye blinking 

Other involuntary movements may include: 

• Making repetitive finger movements like you’re playing the piano 

• Thrusting or rocking your pelvis 

• Walking with a duck-like gait 

• Inability to remain physically still 

These symptoms can range from mild and barely noticeable to severe. 

A healthcare provider may describe these symptoms as: 

• Dystonia- which are uncontrollable muscle contractions 

• Myoclonus- which are brief, sudden muscle movement 

• Buccolingual stereotypy- which are repetitive movements of your mouth 

• Tics- which are habitual contractions of your muscles, often in your face 

Certain risk factors can increase the risk of developing tardive dyskinesia, including: 

• Age: People over the age of 40 are more likely to develop TD. Those who are over the age of 65 are especially at risk due to age-related neurological changes 

• Sex: Females are more likely to develop TD. Those who are in post-menopause have rates of TD as high as 30% after almost a year of exposure to antipsychotic medications 

• Race: Studies show that Black Americans are more likely to develop TD than white Americans. And people of Filipino and Asian descent have a lower risk of developing TD than people of Caucasian descent 

• Bipolar disorder: People with bipolar disorder who take antipsychotic medications are more sensitive to developing TD compared to other people taking the same medications 

To diagnose tardive dyskinesia, a healthcare provider will ask about your symptoms, medical history, and medication history. If you take any medications that are known to cause tardive dyskinesia, your healthcare provider may suspect TD. They may refer you to a neurologist, movement disorder specialist, or psychiatrist.  

Healthcare providers refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose tardive dyskinesia. It states that symptoms of TD must last for at least one month after stopping the medication to get a diagnosis of the condition. You must have been on medication for at least three months if you’re younger than 40 or younger, or one month if you’re over 40.  

A healthcare provider may recommend other tests to confirm TD or rule out other conditions with similar symptoms, such as Huntington’s disease, using laboratory tests and imaging tests such as a brain CT scan and/or MRI.  

A healthcare provider will determine what treatment plan is right for you depending on several factors, such as: 

• How severe your TD symptoms are 

• How long you have been taking a medication 

• Your age 

• What medication you are taking 

• Associated conditions, such as other neurological disorders 

If you are experiencing symptoms of tardive dyskinesia, you can schedule an appointment with a doctor at Jamaica Hospital Medical Center’s Ambulatory Care Center by calling (718) 206-7001. 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.