What medications treat tardive dyskinesia?

Tardive dyskinesia (TD) is an involuntary movement disorder that was first documented in the 1950s to describe a condition that affected patients who were taking neuroleptic medications. Also called antipsychotic medications, neuroleptic medications are indicated for the treatment of schizophrenia, and are also used to treat bipolar disorder, depression, anxiety, and neurological disorders. TD is also associated with some medications that are used to treat nausea and gastrointestinal disorders.

TD can be a debilitating condition. The involuntary movements a person can experience when they have TD may include:

• Repetitive facial movements like grimacing, blinking, sticking out the tongue, fish-like movements, and chewing motions.
• Grunting, sighing, and chewing sounds.
• Tapping feet, waving fingers, and rapid movements of arms or legs.
• Movement in the trunk or neck, such as twisting, swaying or thrusting (called tardive dystonia, a severe form of the disorder).

These symptoms can be mild in some cases and more severe in others. However, even mild symptoms can have a significant impact on a person’s emotional wellbeing, mental health, and quality of life. TD symptoms can be embarrassing and stigmatizing, which can impact a person’s ability to work, socialize, and manage an existing condition.

Treatment of TD

People who are prescribed drugs that can cause TD should be monitored for symptoms and it is best to identify and treat TD as early as possible. Treatment often involves a change in the neuroleptic medication a person is taking or a change in dosage.

However, even with a change in medication, symptoms can still persist, worsen, become permanent, or take a long time to resolve. Since the 1960s, numerous medications have been used in the treatment of tardive dyskinesia, but the first medications indicated for the treatment of TD became available in 2017.

Medications for TD

Two medications indicated for the treatment of TD were approved by the Food and Drug Administration in 2017. Both medications are vesicular monoamine transporter 2 inhibitors, or VMAT2 inhibitors. These medications do not cure TD, but they can help improve symptoms of TD.

While the exact cause of TD is unknown, it is believed to be caused by alterations in the way that the brain uses neurotransmitters (chemical messengers that enable communication between nerve cells). These changes result in abnormal signaling between nerves and muscles, which is what causes involuntary movements. VMAT2 inhibitors work by regulating the storage and release of neurotransmitters and help control these involuntary movements. VMAT2 inhibitors are also used in the treatment of other involuntary movement disorders, including Huntington’s disease and Parkinson’s disease.

Remember that your best source of information about TD is your healthcare provider. TD is a different experience for every person and different approaches to treatment work better for different people.