Understanding Tardive Dyskinesia and Its Symptoms
Tardive dyskinesia is a disorder characterized by involuntary, repetitive body movements. It is a possible side effect of antipsychotic medications used to treat mental health conditions like schizophrenia and bipolar disorder. Recognizing the symptoms and getting proper treatment can help manage this condition.
What Causes Tardive Dyskinesia?
Tardive dyskinesia is caused by abnormalities in certain brain signaling chemicals like dopamine after prolonged use of antipsychotic drugs. These drugs block dopamine receptors as part of their therapeutic action. Over time, the brain tries to compensate for this chemical imbalance, sometimes overcorrecting in a way that leads to involuntary movements.
Who Is at Risk for Tardive Dyskinesia?
Those at highest risk include:
- People over the age of 65
- Those who have taken antipsychotic medication for over 3 months
- Diabetics or those with metabolic disorders
- Those taking antipsychotics alongside antidepressants, anti-nausea, or anti-anxiety medications
Recognizing Facial Signs and Symptoms
Some of the most common early facial symptoms of tardive dyskinesia include:
- Grimacing: Involuntary spasms and odd expressions of the face
- Lip smacking: Excessive puckering, popping, or smacking of the lips
- Tongue thrusting: Darting, wiggling or thrusting out the tongue
- Eye blinking: Frequent squinting, twitching or forceful blinking
Identifying Other Signs of Tardive Dyskinesia
While facial movements are most common, tardive dyskinesia can also cause repetitive tics and spasms in other parts of the body like:
- Fingers or toes
- Arms or legs
- Diaphragm or abdomen
- Jaw or tongue
Verbal Symptoms
Some people with tardive dyskinesia experience verbal tics like:
- Grunting
- Smacking sounds
- Clicking noises
In some cases, these sounds are triggered by movements of the mouth and tongue.
Breathing Difficulties
Erratic movements of respiratory muscles can also occur, leading to symptoms like:
- Shortness of breath
- Rapid breathing
- Inability to take a deep breath
Gastrointestinal Problems
Involuntary spasms affecting the diaphragm and abdomen may cause issues like:
- Stomachaches: Contracting abdominal muscles can trigger cramps and pain
- Bloating: Erratic diaphragm movements interfere with digestion, causing gas buildup
- Reflux: The dysfunctional opening and closing of throat muscles allows stomach acid back up
Getting an Official Diagnosis
If you suspect you have tardive dyskinesia symptoms, make an appointment with your doctor right away. They will assess your full medical history along with observing your involuntary movements.
Physical Movement Evaluation
Your doctor may videotape your abnormal movements while instructing you to perform various facial gestures and motor tasks. The movements are then scored according to a validated scale.
Brain Imaging
Tests like CT, MRI, PET, or SPECT scans can reveal abnormalities in brain structure, blood flow, and signaling chemicals that underlie tardive dyskinesia.
Medication Adjustments and Monitoring
Your medical team will review all your current medications and make adjustments to mitigate side effects. Ongoing monitoring helps ensure subsequent drug regimens do not provoke involuntary movements.
Available Treatment Options for Tardive Dyskinesia
Treatments focus on managing symptoms by correcting chemical imbalances in the brain. Options may include:
Medication Changes
Lowering antipsychotic dosage or switching medications under medical supervision. This reduces dopamine receptor blockade.
Dopamine-Promoting Drugs
Prescription medications to increase dopamine signaling. Examples include deutetrabenazine (Austedo), valbenazine (Ingrezza), and tetrabenazine (Xenazine).
GABA-Promoting Drugs
Drugs like benzodiazepines and baclofen that increase GABA activity can suppress excess nerve signaling driving involuntary movements.
Botulinum Toxin (Botox) Injections
Botox injections temporarily paralyze muscles, providing localized reduction of severe tardive dyskinesia symptoms.
Steps to Reduce Your Risk
While genetics play a role, you can take proactive measures to lower your risk for tardive dyskinesia:
Carefully Weigh Antipsychotic Use
Discuss all medication options thoroughly with your psychiatrist. In some cases, psychotherapy or other drugs may be reasonable alternatives to chronic antipsychotic use.
Take the Lowest Effective Dosage
Higher antipsychotic doses over long periods increase tardive dyskinesia likelihood. Your doctor can work to find the minimal dosage with satisfactory effects.
Actively Monitor for Side Effects
Pay close attention for early facial tics, verbal noises, or unusual body movements. Promptly report symptoms to adjust treatment before severe issues develop.
While tardive dyskinesia cannot always be prevented, careful antipsychotic use and symptom monitoring provides the best chance at avoiding problems.
FAQs
What medications cause tardive dyskinesia?
Antipsychotics used to treat conditions like schizophrenia and bipolar disorder most commonly cause tardive dyskinesia as a side effect. First-generation antipsychotics like haloperidol have the highest risk.
Can you recover from tardive dyskinesia?
Symptoms may disappear within 6 months after stopping the offending medication in some mild cases. However, moderate to severe tardive dyskinesia often persists and is difficult to reverse once abnormal muscle movements become well-established.
Does stress make tardive dyskinesia worse?
For some people emotional stress, fatigue, excitement, or anxiety can temporarily exacerbate tardive dyskinesia symptoms. Identifying and controlling potential triggers may help reduce frequency and severity.
Are the muscle spasms of tardive dyskinesia painful?
The involuntary tics and spasms themselves are typically not painful. However, erratic prolonged contractions of facial, trunk, and limb muscles can sometimes cause muscle soreness or headaches.
Why do antipsychotics cause tardive dyskinesia?
These drugs block dopamine receptors, causing chemical signaling imbalances over time the brain tries correcting. This can manifest as uncontrolled muscle movements. Higher doses and longer usage increase tardive dyskinesia risk.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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