Tardive dyskinesia

Answer 1

It is, and it happens with many medicines used in psychiatry.

As the name 'tardive' implies, the effects are delayed, so it won't be evident for some time - perhaps years - after a long course of such medications.

Our nerves are coated in a protective myelin sheath. The medication damages the myelin sheath so that the nerves are no longer as insulated as they were. This leads to involuntary movements such as a facial tic, or writhing movements over the body. It is not painful, but it is uncontrollable and embarrassing. Sometimes the tics involve making sounds, gestures or shouting.

These side effects are not very nice, so why are these medicines used? Its a difficult decision that is not taken lightly. Sometimes their use is the only way to make life better for the patient. The hope is that the medicines can be used for a short time and then the patient hopefully improves and can be helped with less drastic medication and psychotherapy. Newer medicines are less damaging, and they are usually prescribed first, but if they don't work and the patient is very ill, then as the lesser of two evils, the heavier drug may be prescribed.

Sometimes anti Parkinsons drugs are prescribed to counter the effects of the medicine that causes tardive dyskinesia, but although they help a bit, they don't help enough for most doctors to feel that adding yet another drug to a patient is a good thing.

There are support groups for people with tardive dyskinesia.

Answer 2

Definition

Tardive dyskinesia is a disorder that involves involuntary movements, especially of the lower face. Tardive means "delayed" and dyskinesia means "abnormal movement."

Causes, incidence, and risk factors

Tardive dyskinesia is a serious side effect that occurs when you take medications called neuroleptics. It occurs most frequently when the medications are taken for a long time, but in some cases it can also occur after you take them for a short amount of time.

The drugs that most commonly cause this disorder are older antipsychotic drugs, including:

• Haloperidol
• Fluphenazine
• Trifluoperazine

Other drugs, similar to antipsychotic drugs, that can cause tardive dyskinesia include:

• Cinnarizine
• Flunarizine (Sibelium)
• Metoclopramide

Symptoms

• Facial grimacing
• Jaw swinging
• Repetitive chewing
• Tongue thrusting

Expectations (prognosis)

If diagnosed early, the condition may be reversed by stopping the drug that caused the symptoms. Even if the antipsychotic drugs are stopped, the involuntary movements may become permanent and in some cases may become significantly worse.

References

Kompoliti K, Horn SS, eds. Drug-induced and iatrogenic neurological disorders. In: Goetz CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 55.

Tardive dyskinesia. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004:chap 148.

Answer 3

Definition

Tardive dyskinesia is a disorder that involves involuntary movements, especially of the lower face. Tardive means "delayed" and dyskinesia means "abnormal movement."

Causes, incidence, and risk factors

Tardive dyskinesia is a serious side effect that occurs when you take medications called neuroleptics. Most often, it occurs when you take the medication for many months or years, but in some cases it can occur after you take them for as little as 6 weeks.

The drugs that most commonly cause this disorder are older antipsychotic drugs, including:

• Chlorpromazine
• Fluphenazine
• Haloperidol
• Trifluoperazine

Other drugs, similar to these antipsychotic drugs, that can cause tardive dyskinesia include:

• Flunarizine (Sibelium)
• Metoclopramide
• Prochlorperazine

Newer antipsychotic drugs seem less likely to cause tardive dyskinesia, but they are not entirely without risk.

Symptoms

• Facial grimacing
• Finger movement
• Jaw swinging
• Repetitive chewing
• Tongue thrusting

Expectations (prognosis)

If diagnosed early, the condition may be reversed by stopping the drug that caused the symptoms. Even if the antipsychotic drugs are stopped, the involuntary movements may become permanent and in some cases may become significantly worse.

References

Kompoliti K, Horn SS, eds. Drug-induced and iatrogenic neurological disorders. In: Goetz CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 55.

Lang A. Other movement disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 434.

Reviewed By

Review Date: 06/15/2010

David C. Dugdale III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.