Back خلل الحركة المتأخر Arabic Discinèsia tardana Catalan Tardive dyskinesier Danish Spätdyskinesie German Discinesia tardía Spanish Tardiivi dyskinesia Finnish Dyskinésie tardive French דיסקינזיה מאוחרת HE Discinesia tardiva Italian 遅発性ジスキネジア Japanese

Tardive dyskinesia

Not to be confused with dyskinetic cerebral palsy.
Tardive dyskinesia
Other namesLinguofacial dyskinesia, tardive dystonia, tardive oral dyskinesia[1]
Tardive dyskinesia is believed to involve the neurotransmitter dopamine.
Pronunciation
SpecialtyNeurology, psychiatry
SymptomsInvoluntary, repetitive body movements[1]
CausesNeuroleptic medications (antipsychotics), metoclopramide[1][2]
Diagnostic methodBased on symptoms after ruling out other potential causes[1]
Differential diagnosisHuntington's disease, cerebral palsy, Tourette syndrome, dystonia[2]
PreventionUsing lowest possible dose of neuroleptic medication[3]
TreatmentStopping neuroleptic medication if possible, switching to clozapine[1]
MedicationValbenazine, tetrabenazine, botulinum toxin[1][4]
PrognosisVariable[1]
Frequency20% (atypical antipsychotics)
30% (typical antipsychotics)[5]

Tardive dyskinesia (TD) is an iatrogenic disorder that results in involuntary repetitive body movements, which may include grimacing, sticking out the tongue or smacking the lips,[1] which occurs following treatment with medication.[6][7] Additional motor symptoms include chorea or athetosis.[1] In about 20% of people with TD, the disorder interferes with daily functioning.[3] If TD is present in the setting of a long-term drug therapy, reversibility can be determined primarily by severity of symptoms and how long symptoms have been present before the long-term drug has been stopped.

Tardive dyskinesia occurs as a result of long-term use of dopamine-receptor-blocking medications such as antipsychotics and metoclopramide.[1][2] These medications are usually used for mental illness but may also be given for gastrointestinal or neurological problems.[1] The condition typically develops only after months to years of use.[1][3] The diagnosis is based on the symptoms after ruling out other potential causes.[1]

Efforts to prevent the condition include either using the lowest possible dose or discontinuing use of neuroleptics.[3] Treatment includes stopping the neuroleptic medication if possible (although this may temporarily worsen symptoms) or switching to clozapine.[1] Other medications such as valbenazine, tetrabenazine, or botulinum toxin may be used to lessen the symptoms.[1][4] With treatment, some see a resolution of symptoms, while others do not.[1]

Rates in those on atypical antipsychotics are about 20%, while those on typical antipsychotics have rates of about 30%.[5] The risk of acquiring the condition is greater in older people,[3] for women, as well as patients with mood disorders and/or medical diagnoses receiving antipsychotic medications.[8] The term "tardive dyskinesia" first came into use in 1964.[3]

  1. ^ a b c d e f g h i j k l m n o p "Tardive dyskinesia". rarediseases.info.nih.gov. 1 June 2017. Archived from the original on 18 June 2017. Retrieved 10 June 2017.
  2. ^ a b c "Tardive Dyskinesia". NORD (National Organization for Rare Disorders). 2015. Archived from the original on 28 August 2017. Retrieved 11 June 2017.
  3. ^ a b c d e f Vijayakumar, D; Jankovic, J (May 2016). "Drug-Induced Dyskinesia, Part 2: Treatment of Tardive Dyskinesia". Drugs. 76 (7): 779–787. doi:10.1007/s40265-016-0568-1. PMID 27091214. S2CID 13570794.
  4. ^ a b "Tardive Dyskinesia Information Page". National Institute of Neurological Disorders and Stroke. Archived from the original on 2017-07-04.
  5. ^ a b Carbon, M; Hsieh, CH; Kane, JM; Correll, CU (March 2017). "Tardive Dyskinesia Prevalence in the Period of Second-Generation Antipsychotic Use: A Meta-Analysis". The Journal of Clinical Psychiatry. 78 (3): e264–e278. doi:10.4088/jcp.16r10832. PMID 28146614. S2CID 3773500.
  6. ^ Gerlach, J.; Casey, D.E. (1988). "Tardive dyskinesia". Acta Psychiatrica Scandinavica. 77 (4): 369–378. doi:10.1111/j.1600-0447.1988.tb05138.x. ISSN 0001-690X. PMID 2898870.
  7. ^ Waln, Olga; Jankovic, Joseph (2013). "An Update on Tardive Dyskinesia: From Phenomenology to Treatment". Tremor and Other Hyperkinetic Movements. 3. doi:10.7916/D88P5Z71 (inactive 2024-11-01). PMC 3709416. PMID 23858394.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  8. ^ Lynn, D. Joanne, Newton, Herbert B. and Rae-Grant, Alexander D. eds. 5-Minute Neurology Consult, 2nd ed. Philadelphia: Lippincott Williams & Wilkins, 2012 [ISBN missing][page needed]

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