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Tardive Dyskinesia

TD is a neurological syndrome characterized by repetitive, involuntary, purposeless movements caused by the long-term use of certain drugs called neuroleptics used for psychiatric, gastrointestinal, and neurological disorders. Features may include grimacing; tongue protrusion; lip smacking, puckering, and pursing; and rapid eye blinking. Rapid movements of the arms, legs, and trunk may also occur. The incidence of the syndrome rises with the dose and duration of drug treatment. The treatment of tardive dyskinesia is usually to stop or minimize the use of the offending drug if possible. Replacing the offending drug with substitute drugs may help.

Causes

Antipsychotic meds treat schizophreniabipolar disorder, and other brain conditions. Doctors also call them neuroleptic drugs. They block a brain chemical called dopamine. It helps cells talk to each other and makes the muscles move smoothly. When you have too little of it, your movements can become jerky and out of control. TD often occurs when you take the drug for many months or years. In some cases, it occurs after you take them for as little as 6 weeks.

Drugs that most commonly cause this disorder are older antipsychotics, including:

  • Chlorpromazine (Thorazine)
  • Fluphenazine (Prolixin)
  • Haloperidol (Haldol)
  • Perphenazine (Amitriptyline)
  • Prochlorperazine (Compazine)
  • Thioridazine (Mellaril)
  • Trifluoperazine (Stelazine)

Newer antipsychotics seem less likely to cause TD, but they are not entirely without risk. Some drugs that treat nausea, reflux, and other stomach problems can also cause TD if you take them for more than 3 months. These include:

  • Metoclopramide (treats stomach problem called gastroparesis)
  • Antidepressant drugs such as fluoxetine, phenelzine, sertraline, trazodone
  • Antiparkinson drugs such as levodopa
  • Antiseizure drugs such as phenobarbital and phenytoin

You’re more likely to get it if you:

  • A woman who has gone through menopause
  • Are over age 55
  • Abuse alcohol or drugs
  • Are African-American or Asian-American