If you’re experiencing uncontrollable movements, you might wonder what's happening. Movements like lip smacking, blinking, chewing motions or repetitive motions of your arms, legs or body could be signs of tardive dyskinesia (TD).
TD is a movement disorder that is often linked to the long-term use of certain prescription medications used for mental health conditions or stomach issues (nausea, gastroparesis). While these movements may seem concerning, effective treatments are available.
At Banner Health, our movement disorder specialists can identify the cause of your symptoms, review your medications and work with your care team to build a treatment plan that's right for you.
TD is a neurological disorder that causes repetitive, uncontrolled muscle movements. It often happens after long-term use of certain medications that block dopamine, a brain chemical that helps control movement and mood.
The word “tardive” means delayed and “dyskinesia” means abnormal movement. There is always a delay between starting the medication and seeing abnormal movements. Some people show symptoms within months while others never develop TD, even after taking these medicines for years.
At first, the involuntary movements may be mild but they can become more noticeable over time. They often affect the face, mouth, tongue, jaw, neck, arms, hands, legs, feet and trunk.
For some, TD is mainly a cosmetic issue. For others, it can make it hard to speak, eat, swallow, walk or do daily activities. Even after stopping or reducing the related medication, symptoms may continue. However, treatment can often help manage these movements.
Medication safety: Do not stop or change your medications without talking to your health care provider. Some medicines that can cause tardive dyskinesia are used to treat serious mental health, digestive or neurological conditions. Stopping these medicines suddenly can be unsafe and might make your symptoms or health problems worse.
Symptoms often begin gradually and may become more noticeable over time. Common symptoms include:
In more severe cases, TD may make it difficult to:
TD is most commonly linked to medications that block dopamine receptors in the brain. Dopamine helps control movement. This change in dopamine signaling may lead to involuntary movements. Other chemicals, including serotonin, acetylcholine and GABA, may also play a role.
TD is most often a side effect of certain medications. These include:
Not everyone who takes these medications develops TD. The following factors may increase your risk:
Several neurological conditions and medication side effects can cause abnormal or involuntary movements. Some can look similar to TD, making it important to get an accurate diagnosis. A neurologist or movement disorder specialist can help determine what is causing symptoms and whether your medications could be contributing.
A tremor is a rhythmic, involuntary shaking that can affect the hands, arms, head or voice. Tremors may happen when a body part is at rest or when you are using it. Some medications, including divalproex, valproic acid and lithium, can cause or worsen tremors.
TD usually causes repetitive, involuntary movements that are less rhythmic than a tremor. These movements often affect the mouth, tongue, face or fingers. For example, you may notice lip smacking, chewing movements, tongue movements or repeated facial movements.
Parkinsonism describes a group of symptoms that can occur with several conditions, including Parkinson’s disease. Certain medications, particularly dopamine-blocking medications such as some antipsychotics, can also cause parkinsonism.
Drug-induced parkinsonism may cause:
These symptoms differ from the repetitive, often irregular movements commonly seen with TD. Because TD and drug-induced parkinsonism can occur in the same person, an accurate diagnosis is important when choosing treatment.
If you develop a new tremor, stiffness, slowed movement or other abnormal movement while taking medication for a psychiatric or neurological condition, talk with your health care provider or ask for an evaluation by a movement disorder specialist.
Since symptoms can take time to develop, diagnosing TD early can be challenging. Your health care provider will diagnose it by examining your symptoms, medical history and current medications.
They will monitor your movements and conduct a physical and neurological exam to rule out other causes of movement issues. Additionally, they may use the Abnormal Involuntary Movement Scale (AIMS) to assess your movements.
Depending on the findings, you might be referred to a general neurologist or a movement disorder specialist.
Treatment for TD depends on your symptoms, your overall health and the medicine you take. The goal is to reduce unwanted movements, improve daily life and prevent symptoms from getting worse. Early treatment can often lead to better results.
If a medicine is causing TD, your provider may lower the dose, switch you to a different medicine or stop it if it is safe to do so. Never stop prescribed medication on your own. Stopping suddenly can make your condition worse or cause withdrawal symptoms.
There are only two FDA approved medications to help reduce the involuntary movements caused by TD. These medicines work by lowering dopamine levels in the brain. If parkinsonism or tremors are misdiagnosed as TD, these medications might make the symptoms worse. Also, if your doctor prescribed benztropine for TD, it could worsen your symptoms. If this happens, it's a good idea to get a second opinion from a movement disorder specialist.
Your provider may recommend therapies to help you stay active and improve your quality of life. These include:
Regular follow-up visits are important in treating the condition. Your provider may use a standardized assessment, such as AIMS, to monitor your symptoms over time. These visits help your care team see whether treatment is working and helps your provider make changes if your symptoms improve or worsen.
See your provider or a specialist if you notice new or worsening involuntary movements, especially if you are taking or have taken medicines linked to tardive dyskinesia. You may also want a second opinion if:
A movement disorder specialist can help determine the cause of your symptoms and whether your treatment is appropriate. You should also seek an evaluation if you have:
Go to the nearest emergency room or call 911 if you experience:
Your care team can recommend treatments, therapies and practical strategies to help reduce symptoms and improve your quality of life. Other steps you can take to manage TD include:
If you're experiencing uncontrolled movements, you deserve answers and expert care. At Banner Health, our movement disorder specialists have experience diagnosing and treating tardive dyskinesia and other neurological movement disorders.
We provide comprehensive care that includes careful evaluation, medication review and personalized treatment options. When necessary, we coordinate with your psychiatrist, primary care provider or other specialists to create a treatment plan that safely manages your movement symptoms and the condition your medication was meant to treat.
Whether your symptoms are mild or impacting your daily life, we are here to help you find the right treatment and support.
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The first signs of tardive dyskinesia are often small, repetitive movements you can't control. These may include lip smacking, tongue movements, chewing motions or frequent blinking.
For some people, symptoms improve after changing medications or starting treatment. For others, TD can be long-lasting or permanent. Early diagnosis and treatment may improve your chances of reducing symptoms.
There is no guaranteed cure for TD. However, treatments can help reduce involuntary movements and improve your quality of life.
TD is most commonly linked to antipsychotic medications used to treat conditions such as schizophrenia, bipolar disorder and severe depression. Some anti-nausea medications that block dopamine can also cause TD, especially when used for a long time.
No. Do not stop or change prescribed medication without talking to your provider. Stopping some medicines suddenly can be unsafe and may make your original condition worse.
Your doctor will review your symptoms, medical history and medication use. They will also perform a physical and neurological exam and may use a screening tool called the Abnormal Involuntary Movement Scale (AIMS) to evaluate your movements.
Treatment may include medication changes, medicines that treat TD, botulinum toxin injections for certain movements and supportive therapies such as speech, physical or occupational therapy.
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