For people living with chronic mental illness, like bipolar disorder or schizophrenia, treatment using antipsychotic medications can not only help them manage day-to-day but can also be life-saving. However, use of antipsychotic medications, especially long term, can potentially lead to developing a rare neurological disorder called tardive dyskinesia (TD).
If you or a loved one is undergoing or considering antipsychotic treatment, here is what you should know about this disorder.
What is tardive dsykinesia?
According to the National Alliance on Mental Illness (NAMI), tardive dsykinesia is, "a movement disorder that may develop months, years and even decades after taking antipsychotic medication." The condition is estimated to affect 10 to 20 percent of people treated with antipsychotic medications, according to Mental Health America.
Antipsychotic medications block dopamine receptors and as a result decrease the amount of dopamine in the body. Dopamine, a chemical in the brain, is responsible for movement coordination.
Steven Garlow, MD, PhD, explained, “It seems like people with bipolar disorder may be more sensitive to the dyskinetic [abnormal movement] properties of antipsychotic drugs than people with schizophrenia.”
Risk Factors
It's important to note that not everyone treated with antipsychotic medications will develop TD. In fact, research shows that the average risk of developing TD with ongoing treatment is between 30 and 50 percent. However, NAMI lists the following as common risk factors:
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- Longer treatment with antipsychotic medications, particularly for people who have taken first generation antipsychotic medications (however, it has also been reported in people who have taken second generation antipsychotic medications)
- Older age of a person receiving these medications, specifically post-menopausal females
- Alcoholism or another substance abuse disorder
- Being female
- Being African American or Asian American
Symptoms
Tardive Dyskinesia is characterized by involuntary and repetitive movements. These include:
- Lip smacking
- Lip puckering and pursing
- Grimacing
- Sticking the tongue out
- Rapid eye blinking; rapid movements of the arms, legs and trunk
- In severe cases, swaying of the hips or pelvic thrusts; speech difficulties; respiratory issues
Diagnosis & Treatment
Other neurological conditions, like Parksinson's disease, stroke and Huntington's disease are also characterized by uncontrollable body movements. Ongoing professional evaluation of those taking medications is necessary to properly diagnose TD. A standardized rating scale, "The Abnormal Involuntary Movement Scale," is used by most psychiatrists to screen for TD at least once annually.
There is not a specific medication that can cure TD. Prevention of TD is ideal, so speak with your doctor immediately if symptoms are present. If TD is confirmed, medication dosage may be decreased or patient may be switched to a different one.Other drugs such as benzodiazepines, adrenergic antagonists, and dopamine agonists may also help.
Supplements like...
...vitamin E and Gingko Biloba are also said to help, but more study is required to prove they can prevent or treat TD.
Resources
Living with TD can be challenging on several levels. For more information or support, look into the following organizations:
Tardive Dyskinesia/ Tardive Dystonia National Assoc.
P.O. Box 45732
Seattle, WA 98145-0732
Phone Number: (206) 522-3166
National Institute of Mental Health
Phone Number: 301-443-4513
Toll Free Number: 1-866-615-6464
Fax Number: 301-443-4279
Email Address: [email protected]
Website URL: www.nimh.nih.gov
National Org. for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-8923
Phone Number: (203) 746-6518
Toll-Free Number: (800) 999-6673
Website URL: www.rarediseases.org
