Understanding Tardive Dyskinesia Symptoms and Treatment

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.

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.