Tardive dyskinesia (TD) is a movement disorder most commonly caused by the long-term use of certain neuroleptic medications (also known as antipsychotic medications), which are used in the treatment and management of schizophrenia and other psychiatric disorders. It can also result from the use of medications that act on dopamine receptors, including medications that treat seizures, Parkinson’s disease, and a stomach disorder called gastroparesis.
The primary symptoms of TD
The primary symptoms of TD are involuntary, repetitive movements. These movements may be fast and jerky or slow and writhing, and can affect the face as well as other parts of the body.
The severity of symptoms varies from person to person. Mild symptoms may not be noticeable unless a person is watching for them. More moderate-to-severe symptoms can interfere with many aspects of day-to-day functioning and lead to complications.
Complications associated with TD
In addition to involuntary movements, other symptoms and complications have been associated with TD. Some can occur as a result of involuntary movements and how those movements interfere with normal functioning. Others are the result of multiple contributing factors.
As a person living with TD or a caregiver for a person living with TD, it’s important to understand the different symptoms that can occur as a result of the condition or occur alongside the condition. Your healthcare team will rely on you to report changes in symptoms or potential complications.
Here are some things to watch for and discuss with your healthcare provider:
Dental and oral health issues
Dental problems commonly occur with TD for several reasons. TD symptoms can interfere with brushing and flossing routines, dry mouth is common, and repetitive motions of the mouth and jaw can also cause wear and damage to teeth. TD also presents additional challenges in the treatment of dental problems.
Problems with speech and communication
TD commonly affects the muscles of the mouth and face and can interfere with a person’s ability to speak. Symptoms to watch for include slurred speech, speech that is difficult to understand, and requiring more effort to speak.
Swallowing problems
Involuntary movements of the tongue, jaw, and throat can interfere with a person’s ability to swallow. This can lead to problems with nutrition, dehydration, and choking. Problems eating can lead to poor nutrition.
Difficulty breathing
TD can also affect the respiratory muscles like the diaphragm, the muscles that move air in and out of the lungs. This is sometimes called “respiratory dyskinesia.” While this is not common, it can and does occur, and it can lead to asphyxiation.
Cognitive changes
Some research has associated TD with cognitive impairment, such as problems with thinking, concentration, and memory. Contributing factors may include an underlying mental health condition, changes to the brain, the social and psychological impact of TD, or side effects of the medications that also caused TD. This is an area where more research is needed.
Difficulty with balance and coordination
TD symptoms that affect the limbs or trunk can lead to gait abnormalities (changes in how a person walks) and difficulties with balance. In severe cases, this can increase a person’s risk of falls.
Social and emotional impact
Beyond the physical symptoms and complications of TD, the condition has a significant impact on a person’s psychological and social wellbeing. For example, visible symptoms can make work difficult or cause a person to avoid social situations. Counseling and support are considered essential parts of treatment.
TD is a complex disorder. While knowledge of this condition and its impact has improved, research is ongoing, and there is still much about TD that is not fully understood. Many of the health concerns outlined above can have multiple causes or multiple contributing causes. As a person living with TD (or a caregiver), your best course of action will be working with a healthcare provider to understand your health and your healthcare needs.
Sources: Muhammad Atif Ameer, Preeti Patel, and A... + 13
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