Is Tardive Dyskinesia Reversible?

Side effects from certain drugs like antipsychotics can cause tardive dyskinesia (TD). People experiencing TD symptoms often wonder if the condition is permanent. Two FDA-approved medications are now recommended as first-line therapies for TD.

This article discusses when TD can be reversed and how to manage and live with the condition.

Common Symptoms and Severity

TD symptoms range from mild to severe. The onset of symptoms tends to be gradual and can go unnoticed. So, it's important to be on the lookout for early signs of TD, such as subtle uncontrollable movements.

Over time, mild symptoms can progress to moderate or severe.

Common symptoms of TD include:

• Facial grimacing (making faces)
• Tongue protrusion
• Lip-smacking 
• Mouth puckering
  
• Excessive eye blinking
• Writhing trunk movements
• Jerking hand, arm, or leg movements

The uncontrollable physical movements caused by TD can also cause tremendous psychological distress. People with TD may feel embarrassment or shame. This emotional toll often disrupts people's social lives and affects their overall well-being.

Coping with tardive dyskinesia involves addressing physical, emotional, and social issues.

Who Is at Risk of Developing TD?

It isn't fully understood why some people develop TD or have more severe symptoms than others. That said, specific risk factors seem to make some people more likely to develop the condition.

The risk of developing tardive dyskinesia increases the longer someone takes antipsychotic or dopamine-blocking medications, or any causative drug. Medication-induced symptoms may develop after one to two years, and severity escalates over time. Taking higher doses also increases a person's risk.

Older adults are particularly vulnerable to developing persistent TD. While younger people are still at risk, the prevalence rate is much greater in older adults. 

Women statistically have a higher risk of developing tardive dyskinesia than men. Among postmenopausal women, TD can reach an incidence rate of 30% after one year of exposure to antipsychotics.

Ways to Reverse Tardive Dyskinesia

Before 2017, there weren't any medications approved by the Food and Drug Administration (FDA) to treat or reverse the symptoms of tardive dyskinesia.

Until recently, the standard treatment for reversing TD symptoms was stopping or changing the dosage of the causative drug. However, there is little evidence to support this practice, and two FDA-approved medications are now recommended as first-line therapies.

Medications for Tardive Dyskinesia

The FDA recently fast-tracked and approved two new medications for tardive dyskinesia:

• Ingrezza (valbenazine)
• Austedo (deutetrabenazine)

Both of these drugs are vesicular monoamine transporter type 2 (VMAT2) drugs. VMAT2 medications have robust therapeutic effects and have been shown to successfully treat patients with moderate to severe tardive dyskinesia symptoms.

TD medications are best prescribed as part of a comprehensive management strategy that a patient openly discusses with their healthcare provider throughout the process.

Natural Remedies

A 2016 analysis of multiple studies concluded that supplemental ginkgo biloba therapy might be an effective and safe option for helping improve TD symptoms. However, the authors noted that more and better trials are necessary to determine this.

Always discuss potential drug interactions or possible adverse side effects of natural remedies with your healthcare provider before taking any over-the-counter (OTC) supplements.

Summary

Tardive dyskinesia is a movement disorder that results from the use of antipsychotic medications. It is often permanent, but, in some cases, it can be reversed with some of the newer FDA-approved therapies, Ingrezza and Austedo. Early detection and prevention are among the best management strategies for TD symptoms.

A Word From Verywell

Tardive dyskinesia can develop unexpectedly, and in ways that are often not noticeable at first. Because early treatment and prevention are your best defense against developing irreversible TD symptoms, it's important to maintain an open dialogue with your healthcare provider. This is especially true if you start taking antipsychotics or other TD-causative drugs.