Tardive Dyskinesia

(TD)

Definition

Tardive dyskinesia (TD) is a neurologic syndrome. It results from using neuroleptic drugs—also called antipsychotic drugs. This class of drugs is used to treat psychiatric conditions, like schizophrenia . TD consists of a group of symptoms including:
  • Abnormal twisting movements
  • Abnormal postures due to sustained muscle contractions

Causes

It is unclear exactly why TD develops. Long-term use of neuroleptic drugs can cause changes in the chemistry in the brain that lead to the symptoms. Nerve cells may also become overly sensitive to certain substances. Not everyone who takes these drugs develops TD.

Risk Factors

TD is more common in women and in people over the age of 54. Other factors that may increase your risk of TD include:
  • Use of neuroleptic drugs, especially if the drugs:
    • Are taken in high doses for longer than 6 months
    • Are first generation drugs, which are the first drugs developed to treat a condition
  • Use of metoclopramide and prochlorperazine—These medications are used to treat gastrointestinal problems, like nausea, vomiting, delayed bowel emptying, and gastroesophageal reflux disease (GERD), especially if taken more than 3 months
  • Possible genetic factor
  • Having a disease that may require using neuroleptic drugs, such as:
    • Mood or other psychiatric disorders
    • Behavior problems that occur with psychiatric or neurologic disorders, such as agitation in Alzheimer’s disease
    • Digestive disorders

Symptoms

TD causes repetitive movements. Movements usually occur in the face, mouth, limbs, or trunk. The movements are involuntary and serve no purpose. They may occur occasionally or all of the time. They may or may not be noticeable. Symptoms may begin while on the drug or within weeks of stopping it.Symptoms may include:
  • Grimacing
  • Sticking out the tongue
  • Twisting the tongue
  • Chewing
  • Sucking
  • Smacking lips
  • Puckering lips
  • Blinking eyes
  • Facial tics
  • Foot tapping
  • Moving fingers as if playing the piano
  • Rapidly moving arms, legs, or body
  • Writhing movements
  • Pelvic thrusts
  • Grunting
  • Sighing
  • Noisy breathing
They can worsen with:
  • Stress
  • Moving other parts of the body
  • Taking certain drugs
Symptoms may decrease with:
  • Relaxation
  • Sleep
  • Purposely moving the affected body part

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