Tardive dyskinesia: Difference between revisions

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Tardive dyskinesia is a neurological syndrome caused by the long-term use of neuroleptic drugs.  
{{SI}}
 
{{Infobox medical condition
== Neuroleptics ==
| name            = Tardive dyskinesia
Neuroleptic drugs are generally prescribed for psychiatric disorders, as well as for some gastrointestinal and neurological disorders.
| image          = [[File:Dopamine-3d-CPK.png|left|thumb|Dopamine]]
 
| caption        = Dopamine, a neurotransmitter involved in tardive dyskinesia
== Clinical features ==
| field          = [[Psychiatry]], [[Neurology]]
Tardive dyskinesia is characterized by repetitive, involuntary, purposeless [[movements]].
| symptoms        = Involuntary movements, especially of the lower face
 
| complications  = Social stigma, impaired quality of life
<youtube>
| onset          = Months to years after starting [[antipsychotic]] medication
title='''{{PAGENAME}}'''
| duration        = Often chronic
movie_url=http://www.youtube.com/v/x35JDyBfd8k
| types          = [[Tardive dystonia]], [[Tardive akathisia]]
&rel=1
| causes          = Long-term use of [[dopamine receptor]] blocking agents
embed_source_url=http://www.youtube.com/v/x35JDyBfd8k
| risks          = Use of [[antipsychotics]], older age, female gender
&rel=1
| diagnosis      = Clinical evaluation
wrap = yes
| differential    = [[Parkinson's disease]], [[Huntington's disease]], [[Tourette syndrome]]
width=750
| prevention      = Use of lowest effective dose of antipsychotics, regular monitoring
height=600
| treatment      = Discontinuation or reduction of causative agent, use of [[VMAT2 inhibitors]]
</youtube>
| medication      = [[Valbenazine]], [[Deutetrabenazine]]
 
| prognosis      = Variable; some cases improve, others persist
| frequency      = 20-30% of patients on long-term antipsychotics
}}
{{DISPLAYTITLE:Tardive Dyskinesia}}
'''Tardive dyskinesia''' is a neurological disorder characterized by involuntary, repetitive body movements. These movements can include grimacing, tongue movements, lip smacking, and rapid eye blinking. The condition is often associated with long-term use of [[antipsychotic]] medications, particularly the older, first-generation antipsychotics.
== Pathophysiology ==
Tardive dyskinesia is believed to result from the long-term blockade of [[dopamine]] receptors in the brain. Antipsychotic medications, which are used to treat conditions such as [[schizophrenia]] and [[bipolar disorder]], often target dopamine receptors to reduce symptoms of psychosis. However, chronic use of these medications can lead to an imbalance in the dopaminergic system, resulting in the development of tardive dyskinesia.
== Symptoms ==
== Symptoms ==
* Features of the disorder may include grimacing, tongue protrusion, lip smacking, puckering and pursing, and rapid eye blinking.  
The symptoms of tardive dyskinesia can vary in severity and may include:
* Rapid movements of the arms, legs, and trunk may also occur. Involuntary movements of the fingers may be present.
* Involuntary movements of the face, such as grimacing and lip smacking.
 
* Rapid eye blinking.
== Prognosis ==
* Tongue movements, including protrusion and rolling.
* Symptoms of tardive dyskinesia may remain long after discontinuation of neuroleptic drugs.  
* Involuntary movements of the limbs and trunk.
* In many cases, the symptoms stop spontaneously, but in some cases they may persist indefinitely.
== Diagnosis ==
 
Diagnosis of tardive dyskinesia is primarily clinical, based on the observation of characteristic involuntary movements. A thorough medical history and review of medication use are essential to differentiate tardive dyskinesia from other movement disorders.
== Treatment ==
== Treatment ==
* Treatment is highly individualized. The first step is generally to stop or minimize the use of the neuroleptic drug, but this can be done only under close supervision of the physician.
Treatment of tardive dyskinesia involves discontinuing or reducing the dose of the offending antipsychotic medication, if possible. Switching to a newer, atypical antipsychotic with a lower risk of causing tardive dyskinesia may also be beneficial. In some cases, medications such as [[tetrabenazine]] or [[valbenazine]] may be used to manage symptoms.
* Replacing the neuroleptic drug with substitute drugs may help some individuals.  
== Prevention ==
* The Food and Drug Administration has approved valbenazine capsules to treat adults with tardive dyskinesia.  
Preventing tardive dyskinesia involves careful monitoring of patients on antipsychotic medications, using the lowest effective dose, and regularly assessing the need for continued treatment. Early detection of symptoms can help mitigate the progression of the disorder.
* The drug tetrabenazine is usually effective but can have side effects that need to be discussed prior to starting therapy.  
== See also ==
* Other drugs such as benzodiazepines, clozapine, or botulinum toxin injections also may be tried.
* [[Antipsychotic]]
{{stub}}
* [[Dopamine]]
{{neuro}}
* [[Schizophrenia]]
* [[Bipolar disorder]]
[[Category:Neurological disorders]]
[[Category:Neurological disorders]]
[[Category:Symptoms and signs: Nervous system]]
[[Category:Movement disorders]]
[[Category:Syndromes]]
[[Category:RTT]]
[[Category:RTTNEURO]]
[[Category:Tardive dyskinesia]]

Latest revision as of 19:33, 8 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Tardive dyskinesia
Dopamine
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Involuntary movements, especially of the lower face
Complications Social stigma, impaired quality of life
Onset Months to years after starting antipsychotic medication
Duration Often chronic
Types Tardive dystonia, Tardive akathisia
Causes Long-term use of dopamine receptor blocking agents
Risks Use of antipsychotics, older age, female gender
Diagnosis Clinical evaluation
Differential diagnosis Parkinson's disease, Huntington's disease, Tourette syndrome
Prevention Use of lowest effective dose of antipsychotics, regular monitoring
Treatment Discontinuation or reduction of causative agent, use of VMAT2 inhibitors
Medication Valbenazine, Deutetrabenazine
Prognosis Variable; some cases improve, others persist
Frequency 20-30% of patients on long-term antipsychotics
Deaths N/A


Tardive dyskinesia is a neurological disorder characterized by involuntary, repetitive body movements. These movements can include grimacing, tongue movements, lip smacking, and rapid eye blinking. The condition is often associated with long-term use of antipsychotic medications, particularly the older, first-generation antipsychotics.

Pathophysiology[edit]

Tardive dyskinesia is believed to result from the long-term blockade of dopamine receptors in the brain. Antipsychotic medications, which are used to treat conditions such as schizophrenia and bipolar disorder, often target dopamine receptors to reduce symptoms of psychosis. However, chronic use of these medications can lead to an imbalance in the dopaminergic system, resulting in the development of tardive dyskinesia.

Symptoms[edit]

The symptoms of tardive dyskinesia can vary in severity and may include:

  • Involuntary movements of the face, such as grimacing and lip smacking.
  • Rapid eye blinking.
  • Tongue movements, including protrusion and rolling.
  • Involuntary movements of the limbs and trunk.

Diagnosis[edit]

Diagnosis of tardive dyskinesia is primarily clinical, based on the observation of characteristic involuntary movements. A thorough medical history and review of medication use are essential to differentiate tardive dyskinesia from other movement disorders.

Treatment[edit]

Treatment of tardive dyskinesia involves discontinuing or reducing the dose of the offending antipsychotic medication, if possible. Switching to a newer, atypical antipsychotic with a lower risk of causing tardive dyskinesia may also be beneficial. In some cases, medications such as tetrabenazine or valbenazine may be used to manage symptoms.

Prevention[edit]

Preventing tardive dyskinesia involves careful monitoring of patients on antipsychotic medications, using the lowest effective dose, and regularly assessing the need for continued treatment. Early detection of symptoms can help mitigate the progression of the disorder.

See also[edit]