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Tardive Dyskinesia (TD)

Last updated May 4, 2018

Approved by: Maulik P. Purohit MD MPH

Tardive Dyskinesia is a condition, which involves abnormal, involuntary, repetitive body movements.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Drug-Induced Tardive Dyskinesia
  • Movement Disorder
  • Oral Dyskinesia

What is Tardive Dyskinesia? (Definition/Background Information)

  • Tardive Dyskinesia is a condition, which involves abnormal, involuntary, repetitive body movements
  • Involuntary movements mostly involve the facial muscles. They less commonly also involve the limbs, trunk, toes, and fingers
  • Tardive Dyskinesia is commonly seen in patients who are treated with long term, or high dose anti-psychotic medications, and some specific gastrointestinal drugs

Who gets Tardive Dyskinesia? (Age and Sex Distribution)

  • Tardive Dyskinesia can manifest in any individual treated with dopamine antagonist drugs (a type of anti-psychotic drug). Such individuals may be suffering from a psychiatric condition, in most cases
  • There is no inclination to any specific gender or race

What are the Risk Factors for Tardive Dyskinesia? (Predisposing Factors)

The risk factors for Tardive Dyskinesia include:

  • Elderly adult individuals
  • Chronic history of alcohol abuse
  • Individuals affected by diabetes

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Tardive Dyskinesia? (Etiology)

  • It has been observed that the older anti-psychotics like Chlordiazepoxide, Haloperidol, Fluphenazine, and Trifluperazine more frequently cause Tardive Dyskinesia than newer (currently available) antipsychotic drugs
  • Certain anti-emetics like Prochlorperazine and Metoclopramide are also known to cause this side effect

What are the Signs and Symptoms of Tardive Dyskinesia?

Tardive Dyskinesia is also known as Oral Facial Dyskinesia, since most of the involuntary movements seen are on the face and mouth. These include:

  • Facial movements like grimacing, lip smacking, tongue protrusion, and pursing
  • Abnormal jaw movements, repetitive chewing-like motion
  • Rapid eye blinking
  • Finger and hand movements
  • Toe tapping

How is Tardive Dyskinesia Diagnosed?

Accurate diagnosis can be challenging, as there is no single test for Tardive Dyskinesia. Some of the diagnostic methods employed are:

  • Physical examination with evaluation of the individual’s medical history
  • Neuro-psychological evaluation, in order to eliminate other neurologic disorders
  • Serum copper and ceruloplasmin (copper-carrying protein) tests are performed, to rule out Wilson’s disease
  • Thyroid function tests and serum electrolytes
  • Tests to rule out connective tissue disorders and auto immune diseases
  • Serum calcium level
  • Imaging studies, like CT and MRI of brain can exclude other pathological conditions such as tumor, stroke, Huntington disease, and calcification in the mid-brain section (Fahr disease)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Tardive Dyskinesia?

Complications of Tardive Dyskinesia include:

  • The disorder can be socially disabling and may cause the inflicted patients to isolate themselves from the society

How is Tardive Dyskinesia Treated?

Treatment measures for Tardive Dyskinesia are not well established. The current management methods include:

  • The first step is to discontinue the causative drug. However, the disorder may persist after discontinuing the causative drug, sometimes permanently
  • Some of the drugs used for treating this condition anecdotally are vitamin E, levodopa, benzodiazepines, botulinum toxin, reserpine, tetrabenazine and dopamine-depleting agents.

How can Tardive Dyskinesia be Prevented?

  • Tardive Dyskinesia can be prevented by giving a very low dosage of anti-psychotic drug for a very short period of time
  • Use of atypical antipsychotics (known as second generation antipsychotic drugs) is normally preferred. The risk of psychosis should be weighed against the side effects of antipsychotics

What is the Prognosis of Tardive Dyskinesia? (Outcomes/Resolutions)

  • In most cases, Tardive Dyskinesia is incurable and irreversible
  • Individuals older than 50 years of age and those who have been taking Tardive Dyskinesia-causing medication for many years, will have a much more difficult time managing the disorder than a younger person who has only been treated few weeks

Additional and Relevant Useful Information for Tardive Dyskinesia:

The following DoveMed website link is a useful resource for additional information:


What are some Useful Resources for Additional Information?

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Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: June 13, 2013
Last updated: May 4, 2018