6 Things to Know About Tardive Dyskinesia, a Side Effect of Antipsychotics

1. Symptoms Often Include Involuntary Mouth Movements

Tardive dyskinesia symptoms can include involuntary mouth movements that resemble chewing, puckering, smacking, or pursing the lips, which can interfere with your ability to speak or chew. Other common symptoms include rapid eye blinking and tongue thrusting.

Tardive dyskinesia can also have sensory symptoms, such as a burning sensation in the mouth, and some women experience vaginal burning, says Jankovic. Young people with tardive dyskinesia may experience tardive dystonia, which are muscle spasms that may cause involuntary head or neck movements, he says.

2. Symptoms May Not Be Obvious At First

“The onset of tardive dyskinesia is often very subtle,” says Jankovic. “It may initially be manifested by just a feeling of restlessness or the need to move the lips, jaw, or tongue.”

But some people have an immediate reaction to antipsychotic drugs, such as sudden, involuntary, or painful jaw or eye movements.

“That may last a few minutes and may spontaneously resolve,” says Jankovic. “But that often is a signal that there’s more trouble to come. If the person is exposed again to these drugs in the future, it may evolve into this persistent, possibly permanent tardive dyskinesia.”

3. Don’t Stop Taking Antipsychotics Without Your Doctor’s Supervision

If you suspect you have tardive dyskinesia, consult the doctor who prescribed your antipsychotic, says Jankovic.

According to a study, the best screening tool for recognizing and tracking the severity of someone’s tardive dyskinesia is the Abnormal Involuntary Movement Scale. During this simple exam, your doctor will ask a few questions and observe you while you make a few movements.

If your doctor determines you have tardive dyskinesia, they’ll help you develop a plan, which may include tapering your medication dose.

“The drug should not be stopped suddenly by the patient,” says Jankovic. “It should be done under the supervision of the physician and should be done gradually.”

4. Drugs Called VMAT2 Inhibitors May Help Relieve Tardive Dyskinesia

Stopping the medication — under your doctor’s supervision only! — is typically the first step to curbing the symptoms of tardive dyskinesia, says Jankovic.

Another type of medication, called a vesicular monoamine transporter-2 (VMAT2) inhibitor, can also be prescribed to suppress the involuntary movements. Two such drugs, deutetrabenazine (Austedo) and valbenazine (Ingrezza), have been approved by the U.S. Food and Drug Administration for the treatment of tardive dyskinesia.

5. Tardive Dyskinesia Can Take Months to Years to Subside

Your prognosis with tardive dyskinesia depends on several factors. For one, people who have taken higher doses of antipsychotics or have taken them for longer periods tend to have longer-lasting symptoms.

“Almost all patients with tardive dyskinesia have the condition for months or years. And, particularly in elderly women, it may be a persistent, permanent condition,” says Jankovic. “The sooner they bring symptoms to the attention of the physician and gradually discontinue the medication, the greater likelihood that the condition will resolve.”

6. Some People Are More Susceptible to Tardive Dyskinesia Than Others

People with certain risk factors are more likely to develop tardive dyskinesia when taking antipsychotics. According to a review, those risk factors include:

• Older age
• Being female
• An intellectual disability or brain damage
• Negative symptoms of schizophrenia
• Mood disorders or cognitive symptoms in mood disorders
• Certain genetic risk factors
• Taking antipsychotics for a longer time
• Diabetes
• Smoking
• Misuse of alcohol or other substances
• First-generation antipsychotics
• Higher doses of an antipsychotic
• Early parkinsonian side effects
• Taking anticholinergic drugs in addition to antipsychotics
• Certain other movement disorders

Involuntary movements of tardive dyskinesia may be distressing and affect quality of life. But knowing some key facts about the condition, such as the latest treatment options and how to reduce risk factors, can help you take steps to prevent or manage the condition. And by working with your doctor to get regular assessments for tardive dyskinesia symptoms, you can potentially spot problems earlier and address them before they become more difficult to treat.