This condition is characterized by involuntary movements. These
abnormal movements most often occur around the mouth. The disorder may
range from mild to severe. For some people, it cannot be reversed,
while others recover partially or completely. Features of the disorder
may include grimacing, tongue protrusion, lip smacking, puckering and
pursing, and rapid eye blinking. Rapid movements of the arms, legs, and
trunk may also occur. Impaired movements of the fingers may appear as
though the patient is playing an invisible guitar or piano.
Tardive dyskinesia is seen most often after long-term treatment with antipsychotic
medications. There is a higher incidence in women, with the risk rising with age. There is
no way to determine whether someone will develop this condition, and if it develops,
whether the patient will recover. At present, there is no effective treatment for tardive
dyskinesia. The possible risks of long-term treatment with antipsychotic medications must
be weighed against the benefits in each individual case by patient, family, and
doctor.
It is possible that Tardive Dyskinesia may not be the name that you
expected. Your physician may have given you another name for this
disease. Please check the synonyms listed below to find other names for
this specific disorder.
- Linguofacial Dyskinesia
- Oral-facial Dyskinesia
- Tardive Dystonia
- Tardive Oral Dyskinesia
- TD
Neuroleptic drugs are generally prescribed for psychiatric disorders, as well as for
some gastrointestinal and neurological disorders. Tardive dyskinesia is characterized by
repetitive, involuntary, purposeless movements.
There is no standard treatment for tardive dyskinesia. Treatment is highly
individualized. The first step is generally to stop or minimize the use of the neuroleptic
drug. However, for patients with a severe underlying condition this may not be a feasible
option. Replacing the neuroleptic drug with substitute drugs may help some patients. Other
drugs such as benzodiazepines, adrenergic antagonists, and dopamine agonists may also be
beneficial.
Symptoms of tardive dyskinesia may remain long after discontinuation of neuroleptic
drugs; however, with careful management, some symptoms may improve and/or disappear with
time.
A decade ago a hypothesis introduced to explain tardive dyskinesia (TD) implicated free
radicals generated secondary to neuroleptic treatment. Since then many preclinical and
clinical studies have investigated this possibility. These studies suggest that free
radicals are probably involved in the pathogenesis of TD and that vitamin E could be
efficacious in its treatment.
Vitamin E has been suggested to be a promising new treatment for
tardive dyskinesia. However, little is known about the optimum dose.
Twenty patients with tardive dyskinesia whose medication had been
unchanged for at least 1 month were selected and randomly divided into
a treatment group with 11 patients and a control group with nine
patients. The treatment group was started on 600 mg of vitamin E per
day, and this dose was increased over the 7 months of the trial to 1600
mg per day. The medication for the control group was unchanged.
Severity of tardive dyskinesia was rated on the Abnormal Involuntary
Movement Scale. Patients in the treatment group initially showed a
significant response to the lower dose of 600 mg per day. However, this
improvement was not maintained and differences between the two groups
reached significant levels only after the dose of vitamin E was
increased to 1600 mg per day. At this dose, there was a significant and
sustained reduction in the severity of tardive dyskinesia. The results
suggest that vitamin E is of value in the treatment of tardive
dyskinesia and that the optimum dose for treating tardive dyskinesia is
1600 mg per day. In addition, there may be a dose related therapeutic
effect of Vitamin E in tardive dyskinesia.
Vitamin E is a safe, well-tolerated compound that may provide some beneficial effects
in patients suffering from neuroleptic-induced tardive dyskinesia.
The
nutrients mentioned above reflect the major nutritional supplements
that may help the condition. Please do remember however that
nutritional supplementation is an adjunct to medical treatment and in
no way replaces medical treatment.
- Sajjad S.H. Department of Psychiatry, School of Post Graduate Medicine, Keele University, Stoke on Trent, Staffordshire, UK. pca02@keele.ac.uk
