Tardive dyskinesia: Difference between revisions

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Tardive dyskinesia is a neurological syndrome caused by the long-term use of neuroleptic drugs.
{{DISPLAYTITLE:Tardive Dyskinesia}}


== Neuroleptics ==
== Tardive Dyskinesia ==
Neuroleptic drugs are generally prescribed for psychiatric disorders, as well as for some gastrointestinal and neurological disorders.  
[[File:Dopamine-3d-CPK.png|thumb|right|3D model of a dopamine molecule, a neurotransmitter involved in tardive dyskinesia.]]


== Clinical features ==
'''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.
Tardive dyskinesia is characterized by repetitive, involuntary, purposeless [[movements]].  


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== Pathophysiology ==
title='''{{PAGENAME}}'''
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.
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== 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.
* Tongue movements, including protrusion and rolling.
* Involuntary movements of the limbs and trunk.


== Prognosis ==
== Diagnosis ==
* Symptoms of tardive dyskinesia may remain long after discontinuation of neuroleptic drugs.  
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.
* In many cases, the symptoms stop spontaneously, but in some cases they may persist indefinitely.


== 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.
 
* The Food and Drug Administration has approved valbenazine capsules to treat adults with tardive dyskinesia.  
== Prevention ==
* The drug tetrabenazine is usually effective but can have side effects that need to be discussed prior to starting therapy.  
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.
* Other drugs such as benzodiazepines, clozapine, or botulinum toxin injections also may be tried.
 
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== Related pages ==
{{neuro}}
* [[Antipsychotic]]
* [[Dopamine]]
* [[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]]

Revision as of 11:55, 15 February 2025


Tardive Dyskinesia

3D model of a dopamine molecule, a neurotransmitter involved in 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

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

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 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

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.

Related pages