Many people with serious and chronic mental illness, such as schizophrenia, require long term treatment with antipsychotic medications. While ongoing antipsychotic treatment can be very helpful or even life-saving for many people, it comes with the risk of developing tardive dyskinesia.
Tardive dyskinesia is a movement disorder that may develop months, years and even decades after taking antipsychotic medication.
The symptoms of tardive dyskinesia are characterized primarily by random movements of different muscles and the tongue, lips or jaw. In some cases people may experience movements of the arms, legs, fingers and toes. In severe cases, symptoms can include swaying movements of the trunk or hips or muscles associated with breathing.
Some common risk factors for developing tardive dyskinesia include:
- Longer treatment with antipsychotic medications, particularly for people who have taken first generation antipsychotic medications (however, it has also been reported in people who have taken second generation antipsychotic medications)
- Older age of a person receiving these medications, specifically post-menopausal females
- Alcoholism or another substance abuse disorder
- Being female
- Being African American or Asian American
Who Will Develop Tardive Dyskinesia?
Due to many factors, not every person treated with antipsychotic medications will developed tardive dyskinesia. Some studies suggest that that the overall risk of developing TD over the course of one’s ongoing treatment is between 30-50%.
Because there are a number of other medical and neurological conditions, including Parkinson's disease, Huntington's disease and strokes that can cause uncontrollable or strange body movements, a long history of treatment with antipsychotics must be documented before diagnosis with TD is even considered.
Treating Tardive Dyskinesia
The most effective treatment for TD is prevention. A person taking medications should see their psychiatrist for regular evaluations to ensure that any signs of TD are recognized before they become severe. Most psychiatrists will use a standardized rating scale called "The Abnormal Involuntary Movement Scale"—AIMS for short—to screen for TD at least once each year.
Decreasing the dose of one’s antipsychotic medications can also help reduce the severity of symptoms. If this is not possible or does not relieve the symptoms of TD, some psychiatrists may recommend switching from one medication to a different one.
Unfortunately there is no medication that can cure TD. A number of different medications have been studied, including benzodiazepines and supplements, such as Vitamin E, branched chain amino acids, Gingko Biloba, but it remains unclear whether any of them can prevent or treat TD at the current time. The antipsychotic clozapine has been effective in selected cases of TD.