5 Leading Therapies for TD

Tardive dyskinesia (TD) is a challenging movement disorder caused primarily by the use of medications.

For sufferers of TD, the symptoms and signs are all too clear and all too problematic at the wrong time. Characterized by involuntary, repetitive movements, TD often affects the face, tongue, limbs, and trunk. While it can be embarrassing, and even debilitating at times, TD does not have to govern your life.

If you’re one of the 15-30 percent of patients affected by TD due to long-term antipsychotic therapy, you’re not alone. In older populations, as many as half of all people on these medications can experience the condition.

Fortunately, there’s good news right around the corner. In the past, TD was often difficult to treat, requiring medication changes or significant lifestyle adjustments that simply weren’t practical. Now, however, advances in neuroplasticity-based therapies are changing the game.

Are you a health-conscious individual seeking evidence-based solutions?

Then this article’s for you. Let’s dive into the top five leading therapies for TD you’ve probably never even heard of…

1. Repetitive Transcranial Magnetic Stimulation (rTMS)

Although it sounds fancy, rTMS is actually a non-invasive technique. It uses magnetic pulses to stimulate specific brain regions, leading to real and consistent improvements. With repeated use, this approach can improve motor and cognitive function.

Consider how it works. When it comes to TD, rTMS goes directly for areas of the brain like the motor cortex. By doing this, the therapy can improve dysfunctional neural circuits that contribute to those unwanted involuntary movements.

Research indicates that multiple, but short, daily sessions of rTMS can significantly reduce scores on the Abnormal Involuntary Movement Scale (AIMS). This suggests rTMS can effectively dampen TD symptoms, albeit future research should explore this further.

Now, if the sound of magnetic pulses into your brain doesn’t sound like fun, merely consider that these are weak electrical currents. And again, they’re targeted. Through this technique, rTMS can reduce unique sensitivities that lead to TD symptoms. We’re talking about everything from the electrochemical activity in your brain to the way your brain can adapt and modify itself.

Before considering rTMS, speak to a neurologist to assess if it’s suitable for your condition. In some cases, side effects such as mild headaches or scalp discomfort are possible.

2. Physical Therapy Protocols

Less invasive than rTMS, many physical therapy approaches play a critical role in managing TD symptoms. These work generally by boosting your muscle strength, aiding your coordination, and improving your overall posture.

Physical therapy is also ideal for preventing or reducing complications like falls or contractures, which can be a serious issue for people with more severe TD. The beauty of physical therapy is that it’s highly individualized. Therapists can develop personalized protocols, including stretching, relaxation exercises, and postural training, all to counteract TD’s effects.

For example, patients with dyskinesia that impacts the face may benefit from exercises that enhance oral motor control, while those with more limb-associated issues may benefit more from strength training.

It’s also important to note that physical activity promotes synaptic plasticity, which is essentially your brain’s ability to adapt, thereby improving your learning, memory, and even ability to recover from injury. Physical activity even increases levels of something called brain-derived neurotrophic factor (BDNF), which is a protein critical for neural repair.

So get active! Talk to a professional, find a routine that works for you, and build yourself up to greater levels of physical and mental health.

3. Cognitive Exercises

These exercises are basically designed to enhance attention, memory, and executive function, which are all vital to people suffering from TD. Overall, such exercises target cognitive deficits, and the research proves it. Cognitive rehabilitation improves numerous aspects of the brain, whether attentional control or memory retraining, helping to encourage adaptive changes for people’s betterment.

One review in PMC even found that cognitive training can enhance neuroplasticity by strengthening neural connections in the prefrontal cortex, which is a vital area associated with higher thinking and self-control. Researchers speculate that such improvements in self-control may also have downstream effects on motor control – in other words, the effects of TD!

Not sure how to incorporate cognitive exercises?

They don’t have to be anything too fancy or crazy. Tasks like puzzles, memory games, or computer-based cognitive training programs (e.g., Lumosity) are great ways to get engaged. When combined with activities for motor control, such as physical therapy, these cognitive exercises show even greater potential.

4. Vesicular Monoamine Transporter 2 (VMAT2) Inhibitors

VMAT2 inhibitors, such as valbenazine and deutetrabenazine, are medications. Not just medications, but the first FDA-approved medications specifically for TD. These drugs work by impacting the release of an important chemical, dopamine, in the brain. By doing this, these medicines can effectively reduce involuntary movements without significantly changing a patient’s psychiatric treatment.

In patients with schizophrenia or mood disorders, these impacts can mean a world of difference. While other approaches, such as changing medicines or reducing dosage, may impact a patient’s psychiatric stability, VMAT2 inhibitors do not. In other words, these medications are a potential game-changer for people with TD.

As always, patients should work closely with a neurologist or psychiatrist to ensure efficacy. It’s all about finding that balance, so by monitoring changes in mood and behavior, people with TD can both reduce TD’s effects while also keeping their mental health going strong.

5. Deep Brain Stimulation (DBS)

Deep brain stimulation (DBS) typically represents the last resort for sufferers of TD. Basically, it’s for people who have severe symptoms and for whom normal medications and therapies do not work adequately. An invasive procedure, DBS requires that electrodes be surgically implanted in brain regions, such as the globus pallidus internus (GPi), to improve abnormal neural activity.

Thankfully, the research is promising. In some studies, patients with DBS have seen an over 40 percent decrease in symptoms six months following the implantation of electrodes. Of course, this surgical procedure is still relatively new, and as with all cutting-edge approaches, it requires further study.

Health-conscious individuals considering DBS should consult a movement disorder specialist first and foremost. If your condition is severe enough and hasn’t responded to other approaches, DBS might just be right for you. With a specialist at your side, you can effectively weigh the benefits against surgical risks, ensuring you get the best pre-op and post-op care possible.

So, when it’s all said and done, consider your options. Managing your TD more effectively may simply be a matter of getting solid physical therapy or using some cognitive exercises. Or, you may be a case that requires more invasive solutions.

Speak with your healthcare team, find the personalized approach best for you, and begin your journey toward a healthier, happier life without all the headaches of TD!

By Evan Bollinger | Published June 4, 2025