Tardive dyskinesia: examples of involuntary movements

Tardive dyskinesia (TD) is an involuntary movement disorder that occurs as a side effect of taking certain medications. It is most often associated with neuroleptic medications, or “neuroleptics.” Neuroleptics are also known as antipsychotic medications.

Neuroleptic medications are the primary treatment for schizophrenia, a psychiatric disorder that disrupts a person’s ability to interpret reality. People with schizophrenia can experience delusions, hallucinations, fragmented thinking, and difficulties with concentration, decision making, and expressing emotions. In many cases, these symptoms can be debilitating.

Neuroleptics are also used to treat other types of mental illness, including bipolar disorder and major depression. Consequently, TD most often occurs in people who are managing a serious mental illness. TD can also be caused by certain medications that are used to treat nausea and gastrointestinal disorders.

Different types of involuntary movements

The symptoms of TD are involuntary, repetitive, and abnormal movements. These movements can affect the face as well as other parts of the body:

• Facial movements. Examples include rapid blinking, grimacing, frowning, sucking in or puffing out the cheeks, sticking out the tongue, chewing motions, and swinging the jaw. A person may also make involuntary sounds and noises, such as chewing noises, grunting, or sighing.
• Movements in other areas of the body. Examples include tapping feet, tapping or wiggling fingers, rapid movements of arms or legs, and twisting, swaying or thrusting movements in the trunk or neck.

Symptoms and severity of symptoms will vary from person to person. Mild symptoms may not be noticeable unless a person is watching for them. Severe symptoms can cause problems with speaking, swallowing, and breathing.

Monitoring and treatment

People who are taking neuroleptic drugs must be closely monitored for side effects, including TD. This should include regular, in-person meetings with the healthcare provider prescribing the medication. People who have symptoms of TD should see a healthcare provider as soon as possible.

In order to treat TD, a healthcare provider may change the neuroleptic medication a person is taking or change the dosage. Changes to medication should always be made under the guidance of a healthcare provider. Stopping a neuroleptic medication without the guidance of a healthcare provider increases a person’s risk of worsening psychosis symptoms, hospitalization, medical emergencies, suicide, and death.

There are also medications that can help reduce and control the involuntary movements caused by TD. A healthcare provider may prescribe one of these medications.

Mental health emergencies

It is also important to recognize when mental health is an emergency. If you or someone you know is having thoughts of self-harm, suicide, or violence, seek help immediately. Licensed mental health professionals are available at the 988 Suicide and Crisis Lifeline. These professionals can listen to what you have to say and guide you through steps that can help keep you safe. The 988 Suicide and Crisis Lifeline can be contacted by calling or texting 988.