Antipsychotics & Other Medications May Be Causing Tardive Dyskinesia
Tardive Dyskinesia: side effect of many medications
What is Tardive Dyskinesia?
Tardive Dyskinesia is a movement disorder, most commonly caused by the use of neuroleptic drugs. TD usually manifests in involuntary, repetetive facial movements, mouth movements, and sometimes body movements. Here are the symptoms of TD:
- lip smacking
- facial movements
- tongue protrusion
- extremity movements
- rapid eye blinking or twitching
Women and people over the age of 65 are more sensitive to TD when on the offending medications. In older people the metabolism slows down and is not able to process the medication as effectively. Approximately 15-30% of persons who receive long-term treatment with neuroleptics are afflicted with TD.
What Causes Tardive Dyskinesia
TD usually occurs after longer-term use of Antipsychotic and other medications as well (see list below). Often patients who take large doses of these medications are more at risk, especially with prolonged use. Tardive Dyskinesia has no cure and in many cases is a permanent condition. There are a few treatments available, but research show there is little success. In many cases, the best way to treat TD is to prevent it by monitoring the patient regularly, and keeping doses at a minimum. It is advised that at the first signs of TD, the medication should be discontinued (with doctor recommendation of course). With many of the neuroleptic medications, such as the antipshychotics, the discontinuance of the drug often does not guarantee that the TD will stop. In fact, in many cases, the very offending medication may mask the condition, or only allow it to manifest mildly. TD may actually get worse or begin after going off antipsychotic medications. It's really a double edged sword.
Long-term use of Dopamine Antagonists can cause Tardive Dyskinesia. According to TD Center website, "These medications operate by blocking receptors in the dopamine pathway of the brain, which controls voluntary muscles and certain emotional response mechanisms (known as the nigrostriatal pathway)."
Treatments for TD
As I said, there are few effective treatments of TD. There is no scientific proof yet, but some doctors and practitioners suggest vitamin E. I take it, but I don't know if that is why it is better. There are few drugs that may lessen the severity of TD. Tetrabenzine is one that reduces Dopamine levels and sometimes has been known to calm TD symptoms down. Another drug used from time to time is Miraplex (an anti-parkinson's medication). Benzodiazipines (tranquilizers) have had minimal success in reducing the symptoms. Propanolol can sometimes help. Clozapine, and botulinum toxin have been found to be very helpful. There are side effects to some these medications, so caution is needed. Clozapine (not clonidine or clonazapam) has some serious side effects and requires a lot of monitoring and regular blood work.
What Should You Do If You Are on a Neuroleptic Medication?
Talk to your doctor right away and ask questions and let him know your concerns. He will be able to formulate a plan with you to monitor the TD. He may be able to switch you to a medication that has lesser history of causing TD. Prevention and early detection are your best bet to avoiding a serious case of TD.
© Lori Colbo 2011. All rights reserved.
Here is a list of medications that can cause tardive dyskinesia (this is not an exhaustive list):
Abilify (Aripiprazole) Clozaril (Clozapine) (may also treat the condition) Geodon (Ziprasidone) Haldol (Haloperidol) Loxitane / Loxapac (Loxapine) Mellaril (Thioridazine) Navane (Thiothixine) Orap (Pimozide) Piportil (Pipotiazine) Prolixin / Modecate (Fluphenazine) Risperdal (Risperidone) Serentil (Mesoridazine) Seroquel (Quetiapine) Stelazine (Trifluoperazine) Thorazine (Chlorpromazine) Trilafon (Perphenazine) Zyprexa (Olanzapine)
- Asendin (Amoxapine)
- Cocaine and other street drugs
- Elavil (Amitriptyline)
- Nardil (Phenelzine)
- Prozac (Fluoxetine)
- Sinequan (Doxepine)
- Tofranil (Imipramine)
- Zoloft (Sertraline)
- Reglan (metoclopramide)
- Compazine (prochlorperazine)
- Phenergan (promethazine)
Discussion on Drug Treatment Between Patient and Doctor
For More Information on Tardive Dyskinesia See These Websites
- Tardive Dyskinesia Treatment Options - Guidelines for Treating Tardive Dyskinesia
Tardive Dyskinesia Treatment options
- Tardive Dyskinesia & Reglan - Symptoms, Side Effects & Treatments
- Medscape: Medscape Access
A comprehensive over view of Tardive Dyskinesia.
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