Tardive dyskinesia

Tardive dyskinesia is caused by the long-term use of certain types of medications called neuroleptics. Neuroleptic drugs are usually prescribed for psychiatric conditions; less commonly, they may be used to treat gastrointestinal or neurological conditions. Tardive dyskinesia usually develops in people who have taken these medications for many years, although some cases may occur with shorter use of the drugs. It is unclear why some people who take neuroleptic medications develop the signs and symptoms of tardive dyskinesia while others do not.

A diagnosis of tardive dyskinesia is typically made in people who have taken neuroleptic medications for at least three months, have signs and symptoms that are suggestive of the condition, and have undergone testing to rule out other conditions that cause similar features. This testing may include specialized laboratory tests and imaging studies such as computed tomography (CT scan), magnetic resonance imaging (MRI scan), positron emission tomography (PET scan) and single-photon emission computerized tomography (SPECT scan).

The long-term outlook (prognosis) for people with tardive dyskinesia varies. When diagnosed early, the condition may resolve by simply stopping the medication that caused the symptoms. However, some affected people continue to have symptoms long after the neuroleptic drug is discontinued. In these cases, the symptoms can sometimes become permenant and/or worsen over time.

The treatment for tardive dyskinesia varies from person to person. Initial treatment usually consists of discontinuing the use of neuroleptic medications if it is safe for the affected person. In people with severe psychiatric conditions, this may not be an option, although the neuroleptic drug can sometimes be replaced with an alternative medication.

Other medications can be prescribed to specifically treat the signs and symptoms of tardive dyskinesia. In some affected people, these drugs help reduce the severity of involuntary movements. For example, a medication called tetrabenazine has been approved by the US Food and Drug Administration (FDA) for the treatment of tardive dyskinesia. Other drugs such as benzodiazepines, clozapine, or botulinum toxin (Botox) injections also may be tried.