Guide To Diagnosing, Preventing, And Treating Tardive Dyskinesia

Tardive dyskinesia is a syndrome caused by the long-term use of certain medications. Doctors typically prescribe these drugs for psychiatric, neurological, and gastrointestinal tract disorders. This syndrome is characterized by repeating, involuntary movements. These movements are sudden, jerky, stiff, and uncontrollable. Some common symptoms include smacking, puckering, and pursing the lips. Grimacing and rapid blinking are two more examples. Others are the protrusion of the tongue and sudden movements of the legs, arms, and trunk.

The best treatment for tardive dyskinesia is to prevent it from occurring, which is why doctors will use low doses of medication or only use medication for short periods. The first treatment is often adjusting or stopping the medication that caused it when it has already occurred. Some patients will need to take new medication for tardive dyskinesia. Of course, patients should consider all treatment options with their doctor first. It is also beneficial to understand the diagnostic process.

Special Physical Exam

Tardive dyskinesia can be a challenging disorder to diagnose. The exact timing of when symptoms appear can make it hard to determine if the medication was the cause. Fortunately, doctors can use a special physical exam to help rule out tardive dyskinesia in individuals who take medication for mental health conditions. The Abnormal Involuntary Movement (AIM) scale can help identify any abnormal involuntary movements potentially caused by the medication.

The test does not take very long. It is quite effective at catching cases of neurological disorders caused by medication. The test is a series of brief assessments. They involve observing involuntary movements when a patient is asked to concentrate on multiple physical and mental tasks at the same time. These procedures have proven to stimulate the individual and instigate the appearance of movement-related disorders.

Tests For Other Movement Disorders

An individual experiencing symptoms of tardive dyskinesia may need to undergo tests for other movement disorders. Their doctor uses a process of elimination before they can make a tardive dyskinesia diagnosis. Doctors may use imaging tests like CT scans, x-rays, MRIs, genetic testing, an electroencephalogram, and metabolic testing to eliminate cerebral palsy or a stroke as the cause of the patient's symptoms.

In-depth genetic tests on an individual's blood sample can dismiss Huntington's disease. A doctor may use a single-photon emission CT test and a dopamine transporter scan to rule out Parkinson's disease. Doctors can rule out Tourette's syndrome from the possible causes through a thorough medical history and physical exam.

Medications

Some individuals affected by this condition have severe psychiatric disorders that they cannot manage without the medication causing this reaction. In such cases, other medications may be necessary to relieve the abnormal muscle movements. However, this is only done after other treatments have failed. Benzodiazepines have a profound effect on the neurotransmitters in an individual's brain. These medications can reduce the nerve activity in an individual's brain, causing the involuntary movements.

Clozapine is another drug that may be used in a patient who cannot lower or come off their antipsychotic medication. It inhibits receptors in the patient's brain, including acetylcholine receptors. Acetylcholine is an important substance that allows an individual's nerves to tell their muscles to contract. This medication depresses this effect, causing movements to ease in some patients. A botox injection may be used to temporarily paralyze affected muscles.

Natural Supplements

Individuals with this condition may want to consider natural supplements to help manage their symptoms. Ginkgo biloba extract is derived from the leaves of the ginkgo biloba plant and contains many antioxidants. Several studies have shown it has improved several symptoms of tardive dyskinesia. Melatonin, which is naturally found in an individual's body, contributes to their sleep cycle. It can help individuals who experience insomnia as a complication of their involuntary movements. The sedative effects it has on the brain are also helpful during the day. However, it must be in small doses.

The bioactive type of vitamin B6 has long shown success with reducing symptoms in several other movement disorders usually caused by medication. According to recent evidence, this form of vitamin B6 decreases abnormal movements in some individuals with tardive dyskinesia. Vitamin E, a powerful antioxidant, can bind with damaging free radicals in the body known to participate in this condition's pathology. Some affected individuals have successfully stopped the progression of their disorder with vitamin B6 or vitamin E supplementation.

Use The Lowest Dosage Of Medication Possible

As this condition is a complication of medications, some affected individuals may ease their symptoms if they use the lowest dosage of medication possible. Antipsychotics treat mental health conditions, such as bipolar disorder. Tardive dyskinesia typically only occurs in individuals taking these medications for three months or longer. The chances of developing this condition increase the longer an individual takes these medications. Also, the older medications cause it more often than the newer ones. Common medications that cause this disorder include prochlorperazine and thioridazine.

One of the first methods used to improve symptoms is to lower the dose of the medicine causing them. Patients should not taper off these medications without direction from a doctor. The reason is that doing so can be very dangerous and cause withdrawal symptoms. Using the lowest effective dose is also effective at preventing this condition from occurring.

Deep Brain Stimulation

Deep brain stimulation involves doctors implanting electrodes to specific areas of the patient's brain. These regulate abnormal movements and other responses through electrical impulses. These impulses may also affect some chemicals and brain cells. Thankfully, this treatment is controllable. Patients will have a device similar to a pacemaker under their skin in their upper chest. A wire will connect the device to the electrodes and deliver the pulses at the chosen strength.

This is a common treatment for Parkinson's disease. It is used to ease symptoms, specifically uncontrollable movements. It also reduces medication reliance. These two elements are part of why deep brain stimulation is an emerging treatment for tardive dyskinesia. It may help patients who must still take their medication for other conditions since it can reduce reliance.