Is Tardive Dyskinesia Reversible?

Tardive dyskinesia (TD) is a medication-induced movement disorder resulting from adverse effects of antipsychotics. Antipsychotics are drugs used to treat psychosis, a condition affecting how your brain processes information.

TD is primarily caused by drugs that block dopamine receptors in the brain, as well as some anti-nausea medications. Typically, this disorder leads to involuntary movements involving the face, tongue, lips, or eye area, but it can also affect the trunk and extremities.

People experiencing TD symptoms often wonder if the condition is permanent. This article discusses when TD can be reversed and how to manage and live with the condition.

Is Tardive Dyskinesia Reversible?

Is Tardive Dyskinesia Reversible?

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.

TD and Mental Health

A 2021 social listening study (a study tracking social media platforms for mentions of TD) researched how people living with TD feel about their condition. Many patients said they felt anger that they developed TD from medications meant to treat other conditions. They also expressed feeling insecure and afraid of being judged by other people for their TD symptoms.

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.

Approximately 1 in 4 people taking antipsychotics experience tardive dyskinesia symptoms as a side effect.

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.

Always Discuss Medication Changes

Stopping the use of any prescription medication without speaking to your healthcare provider first is extremely dangerous. Never stop taking antipsychotics without consulting your provider.

Medications for Tardive Dyskinesia

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

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.

Frequently Asked Questions

  • Is there a test for tardive dyskinesia?

    Yes, there is a test and tracking tool for tardive dyskinesia. The AIMS (Abnormal Involuntary Movement Scale) test is a 12-item questionnaire your healthcare provider fills out to assess the presence and severity of any movement-related TD symptoms. Once a baseline is established, the AIMS test can track symptom severity over time.

  • How often is tardive dyskinesia permanent?

    Although tardive dyskinesia can be reversed, the condition is permanent in many people. Before the advent of newer FDA-approved medications in 2017, a study from 2014 found a 13% reversibility rate in a group of psychiatric and nonpsychiatric patients. However, new VMAT2 medications show promise for reversing this disorder and making it less likely to become permanent.

  • What drugs can cause tardive dyskinesia?

    One of the most persistent myths about tardive dyskinesia is that it's only caused by "older" first-generation antipsychotics (FGAs). Although people taking FGAs are more likely to develop tardive dyskinesia than those taking second-generation antipsychotics, "newer" antipsychotic medications can also cause TD. Other causative drugs include antiemetics (anti-nausea medications), anticholinergics, antidepressants, and antiepileptic drugs (AEDs).

  • Can you die from tardive dyskinesia?

    TD itself is not usually a life-threatening disorder. That said, there is a robust association between increased mortality rate and TD. But there isn't a predictable association with any specific cause of death and tardive dyskinesia.

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13 Sources
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