What is tardive dyskinesia?

Tardive dyskinesia (TD) is a neurological movement disorder that causes involuntary, repetitive and irregular movements. These movements most often affect the face, mouth, tongue and sometimes the arms or legs.

The name “tardive dyskinesia” means delayed abnormal movement. TD often shows up after taking certain medications for a long time, especially antipsychotic drugs used for mental health. For many people, it develops after months or years. But in some cases, especially for people over 65, it can start within a few weeks.

Research shows that about 1 in 5 people taking antipsychotic medications may develop tardive dyskinesia. While there is currently no cure, there are treatment options available that can help reduce or manage the symptoms to improve daily life. If you or a loved one is taking these medications and notices unusual movements, it’s important to talk to your doctor right away.

patient suffering from tardive dyskinesia working through physical therapy options

Tardive dyskinesia symptoms

Tardive dyskinesia, or TD, causes involuntary movements that usually affect the lips, jaw, tongue and eyes. It can also happen in the upper body, arms, hands, legs and feet.

Symptoms can change from day to day. Movements may be fast and jerky or slow and twisting. They can happen repeatedly, all the time or randomly. Stress can also make symptoms worse.

Common signs include:

  • Facial twitching
  • Frequent blinking or squinting
  • Tongue sticking out or moving side to side
  • Lip puckering or smacking
  • Jaw clenching
  • Rocking or shifting the torso
  • Twisting hands or dancing fingers
  • Curling or gripping toes and feet

When to see a doctor

If you start noticing involuntary movements like twitching, lip smacking or your tongue moving without control, it’s a good idea to talk with your doctor. Getting checked early can help you find ways to manage the symptoms and feel better.

You should see a doctor if these movements make daily tasks harder, cause discomfort or get worse over time. If you take medications that might cause tardive dyskinesia, regular visits with your primary care provider can help you catch symptoms early.

Tardive dyskinesia causes

Tardive dyskinesia is linked to certain medications that affect brain chemicals, especially dopamine. Dopamine helps control movement, and some medicines block its action in the brain, which can lead to involuntary movements seen in this condition.

Other brain chemicals may also be involved, so different types of medications can sometimes cause tardive dyskinesia.

Medications that may lead to tardive dyskinesia include:

  • Some older antipsychotics used to treat schizophrenia and bipolar disorder
  • Certain anti-nausea drugs, like metoclopramide
  • Some antidepressants
  • Some anti-seizure drugs

Risk factors for tardive dyskinesia

Certain factors can increase your chances of developing tardive dyskinesia, especially if you take medications that affect brain chemicals like dopamine. While not everyone with these risk factors will develop the condition, being aware of them can help you and your doctor monitor for early signs.

Common risk factors include:

  • Age: Risk goes up with age, especially after 40. People over 65 have the highest chance of developing TD.
  • Sex: Women, especially after menopause, are more likely than men to develop the condition.
  • Race: Black people have a higher risk than white people. People of Asian or Filipino descent have the lowest risk.
  • Bipolar disorder: Those with bipolar disorder who take antipsychotic medications seem to be more sensitive to developing tardive dyskinesia than others taking the same medications

How is tardive dyskinesia diagnosed?

Tardive dyskinesia can sometimes be difficult to diagnose because its symptoms are similar to those of other movement disorders. If your doctor suspects TD, they’ll start with a detailed review of your medical history and may use several tests to confirm the diagnosis and rule out other conditions.

Medical history

Your doctor will start by reviewing your personal and family health history and asking detailed questions about your symptoms. They’ll want to know when the movements started, how often they happen and whether they’re getting worse. It’s also important to share a complete list of medications you’re currently taking or have taken in the past—especially antipsychotics, anti-nausea medicines or antidepressants.

To be diagnosed with TD, symptoms must:

  • Last at least one month after stopping the medication that may have caused them
  • Develop after at least three months of taking the medication (or one month if you’re over age 40)

Tardive dyskinesia treatment

Tardive dyskinesia can’t be cured, but treatment can help reduce symptoms and improve your quality of life. Your doctor will work with you to create a care plan based on your symptoms, health history and how TD affects your daily activities.

Lowering or stopping the medication causing TD sometimes helps, but this isn’t always possible if it worsens your original condition. Stopping medications also sometimes causes the opposite effect, worsening the symptoms. In some cases, switching from first- to second-generation antipsychotics may reduce symptoms.

The most effective treatments are VMAT inhibitors like deutetrabenazine and valbenazine. These medications are safe and have been proven to reduce TD symptoms, especially when they interfere with daily life. Therapy and mental health support can also improve coping and well-being. Regular follow-ups with your doctor will help adjust your treatment as needed.

Find specialized care for tardive dyskinesia near you

At Baylor Scott & White, we offer specialized care and treatment for tardive dyskinesia at neurology centers located across North and Central Texas. Receive personalized care from a team dedicated to your health and well-being. Whether you're seeking diagnosis, treatment options or need ongoing management, we are here by your side.

Frequently asked questions

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