Involuntary Movement: Is it Tardive Dyskinesia?

Tardive Dyskinesia is a neuroleptic induced movement disorder (NIMD) in which patients experience involuntary movement of various body parts, most often centered in or beginning with the oro-facial muscles and potentially effecting the limbs, digits and neck and even the respiratory system.

What Causes Tardive Dyskinesia?

Tardive Dyskinesia is caused by taking antipsychotic or "neuroleptic" medications such as Thorazine and a whole host of newer dopamine receptor blocking drugs (DRBD). "Tardive" means "late onset" and refers to the condition taking effect after prolonged use (three months or more) of the drugs. "Dyskinesia" means "movement disorder" and describes the involuntary and purposeless nature of the movement.

What Are the Symptoms of Tardive Dyskinesia?

Often patients with Tardive Dyskinesia do not notice the symptoms, at least in the beginning. Earliest and most common symptoms generally center in the oro-facial muscles and may include involuntary blinking, lip-licking, clucking the tongue or constantly rubbing it on the teeth. Involuntary finger or toe movements are also possible.

According to Baylor College of Medicine, more severe cases of Tardive Dyskinesia may be defined as: "... an involuntary, coordinated, patterned, repetitive, rhythmic, ritualistic, purposeless (but seemingly purposeful) movement, posture or utterance". It may effect a single body part, such as a hand or the face or may involve whole regions of or even the entire body.

Additionally, Baylor College of Medicine goes on to describe other manifestations of the syndrome such as "chewing, blowing, licking, lip smacking and pursing, facial grimacing, tongue protruding" as well as "hand and toe waving, touching and picking, rubbing of face, scalp and other body parts, head nodding, body rocking, shallow and rapid breathing", etc. Patients may also make a variety of noises such as humming or moaning.

How Is Tardive Dyskinesia Diagnosed?

If you are experiencing any one or any combination of the above mentioned involuntary motion or sound disorders and are taking a neuroleptic or any psychiatric medication, you should immediately contact your physician. Your doctor should be aware of the possible side effects of your medication and can determine if your symptoms are related to that drug or combination of drugs.

Can Tardive Dyskinesia Be Prevented?

Although not all patients will manifest Tardive Dyskinesia when taking neuroleptic medications, the only known way to prevent it is to not take offending neuroleptics in the first place. Newer versions of the anti-psychotics have had greater success in avoiding the syndrome. If your doctor attempts to prescribe an anti-psychotic or neuroleptic medication, be sure to discuss the side effects and any concern you may have about this condition.

How Can Tardive Dyskinesia Be Treated or Cured?

Once a patient is exhibiting the symptoms of Tardive Dyskinesia, there is no definite cure for the syndrome. Stopping the offending medication as soon as possible is the best way to prevent the symptoms from getting worse, but you should NEVER stop or adjust your medication without consulting your physician. Your doctor may be able to put you on another anti-psychotic that will help your mental or emotional symptoms but will avoid worsening the Tardive Dyskinesia syndrome.

There is, however, no known cure for Tardive Dyskinesia. Once symptoms have started, they may be permanent, although often reduced with the physician assisted removal of the drug. Various medications have been tried and have shown some success but, in many patients, may actually exacerbate the condition.

Remember to always consult your physician before taking, adjusting or stopping any prescription medication.

Sources:

Baylor College of Medicine: http://www.bcm.edu/neurology/patient_education/pdcmdc/td.html

TD Center, TardiveDyskinesia.com: http://www.tardivedyskinesia.com/symptoms/

National Institute of Neurological Disorders and Stroke: http://www.ninds.nih.gov/disorders/tardive/tardive.htm