What are the symptoms of tardive dyskinesia (TD)?

Tardive dyskinesia (TD) is an involuntary movement disorder that affects some people who are taking neuroleptic medications. Also known as antipsychotic medications, neuroleptic medications are used to treat serious mental illnesses, including schizophrenia and bipolar disorder.

Neuroleptic drugs are also sometimes prescribed off-label, meaning they are prescribed to treat a condition that falls outside the indication approved by the U.S. Food & Drug Administration. Neuroleptics have been prescribed for depression, generalized anxiety disorder, eating disorders, agitation, post-traumatic stress disorder, and other mental health conditions.

In addition to neuroleptics, TD can be caused by certain medications for other medical conditions, including Parkinson’s disease, nausea, allergies, malaria, and seizures. Potential risks and side effects should always be discussed with a healthcare provider before starting any medication for any condition.

While taking neuroleptics or other medications that can cause TD, a person should be closely monitored for side effects, including involuntary movements. Monitoring should include regular, in-person meetings with the healthcare provider prescribing the medication.

If you or a loved one is taking a medication that can potentially cause TD, it’s important to recognize the symptoms—and to know how to report symptoms to your healthcare provider.

What are the symptoms of TD?

The symptoms of TD include jerky, repetitive movements that may occur in the face or other areas of the body. Common examples include:

• Grimacing, blinking, sticking out the tongue, fish-like movements, chewing motions, repeated sighing or grunting
• Tapping feet, waving fingers, and rapid movements of arms or legs
• Twisting, swaying, or thrusting movements in the trunk or neck

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

What to do if you or a loved one experiences TD symptoms

A person who is experiencing symptoms like those described above should see a healthcare provider for an evaluation as soon as possible. TD is a progressive condition where symptoms become more severe over time. Treatment for TD should begin as early as possible.

A healthcare provider can evaluate symptoms. A diagnosis of TD can include:

• A physical exam, neurological exam, and medical history, including current medications and medications taken in the past
• The Abnormal Involuntary Movement Scale (AIMS), where a healthcare provider will observe for involuntary movements and ask questions about symptoms
• Imaging tests to help rule out other conditions that can cause involuntary movements

If you or a loved one is diagnosed with TD, your healthcare provider will recommend treatment, which may include careful adjustments to current medications and/or medications called VMAT2 inhibitors, which can help control involuntary movements.

What NOT to do if you or a loved one has TD symptoms

Do not stop taking a medication or reduce the dosage of a medication that might be causing TD unless directed to by a healthcare provider.

Involuntary movements can worsen when medication is stopped. This applies to both neuroleptics and other types of medications that are associated with TD.

Stopping a medication that is being used to manage a mental health condition can also cause a relapse of symptoms. This includes relapses of psychosis and mental health emergencies.

It’s also worth mentioning that a pharmacist can be an excellent source of information about medications, including side effects, drug interactions, and what to do if you experience a symptom that could be a medication side effect.