Introduction
When first- and second-generation antipsychotics, as well as drugs like metoclopramide, which are used to treat nausea and gastrointestinal dysmotility, block the dopamine receptor, the consequence is a hyperkinetic movement disorder known as tardive dyskinesia. Although tardive dyskinesia can afflict individuals of any age, older age is linked to a higher risk of tardive dyskinesia and the onset of tardive dyskinesia following shorter treatment durations and lower doses of dopamine receptor blocking agents. Associated with a higher risk of comorbidities, social stigma, and compromised physical and mental health, tardive dyskinesia is typified by uncontrollable movements of the face, limbs, and trunk.
What Is Tardive Dyskinesia?
The movement condition known as tardive dyskinesia (TD) is typified by erratic, aberrant, and repetitive motions of the face, chest, and other body parts. Antipsychotics, which are often recommended to treat mental diseases including schizophrenia, bipolar disorder, and depression, as well as several anti-nausea drugs, are among the therapies that block dopamine receptors in the brain and are the cause of tardive dyskinesia. It is believed that these medicines cause abnormal dopamine signaling in the part of the brain responsible for motor control in people with tardive dyskinesia.
Tardive dyskinesia symptoms can frequently be incapacitating and long-lasting. Because of the symptoms and how they affect social and emotional well-being, people's lives may be disrupted by the uncontrollable movements.
What Causes Tardive Dyskinesia in Older Adults?
1. Antipsychotic medications treat a variety of brain disorders, including bipolar disorder and schizophrenia. These medications are also referred to as neuroleptics by doctors.
2. They inhibit the neurotransmitter dopamine. It facilitates communication between cells and maintains smooth muscle contraction. People who do not have enough of it may move jerkily and uncontrollably.
3. People who use antipsychotic medications may develop tardive dyskinesia. Usually, people have to use it for at least three months. However, there have been a few isolated instances of it following a single antipsychotic medication dosage. This issue is likely higher with older versions of these medications than with newer ones.
Antipsychotic drugs that can result in tardive dyskinesia include:
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Haloperidol.
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Fluphenazine.
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Risperidone.
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Olanzapine.
Certain medications used to treat reflux, nausea, and other stomach issues might also result in tardive dyskinesia if a patient takes them for longer than three months. Among these are:
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Prochlorperazine.
Individuals who are more likely to contract are:
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Women who are undergoing menopause.
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Individuals are older than 55.
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Misuse of drugs or alcohol.
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Asian American or African-American.
What Are the Symptoms Associated WithTardive Dyskinesia?
In those with tardive dyskinesia, modest symptoms affect about 7 out of 10 individuals. Over time, however, symptoms may worsen. In times of stress, they could also get stronger. Tardive dyskinesia frequently disappears during sleep.
The following involuntary facial movements may go unnoticed by people with tardive dyskinesia:
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Blinking quickly.
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Chewing motions.
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Scowling or grimacing.
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Licking one's lips or producing oral suction movements.
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Extending one's tongue or using it to probe the interior of the cheeks.
The body might experience various effects from tardive dyskinesia. An individual could:
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Rock or thrust the pelvis.
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Have the walk of a duck.
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Make repeated finger movements, as if one were playing the piano.
How Long Do Tardive Dyskinesia Symptoms Last?
Tardive dyskinesia usually disappears or decreases when a person stops using a medication or reduces the dose. However, some people's symptoms continue even after the medicine is stopped. Before altering a medication or dose, consult with the healthcare practitioner.
How Is Tardive Dyskinesia Diagnosed?
The doctor will keep an eye out for issues if the patient is taking medication that might result in tardive dyskinesia.
The doctor could suggest specific testing if symptoms appear. Other movement diseases, such as Parkinson's disease, can be ruled out with these tests.
These examinations consist of:
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Examination of the neurological system by physical means.
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Tests for infections, diseases, and other issues can be performed on the blood and urine.
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Brain electrical activity is measured using an electroencephalogram (EEG).
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An electroencephalogram is a technique used to quantify how well muscles and nerves communicate.
What Are the Complications of Tardive Dyskinesia?
People with tardive dyskinesia may become self-conscious. People can distance themselves from one another. However, loneliness can exacerbate or even cause anxiety or depression. The illness may make it more difficult to work. It might also cause tension in relationships with close ones.
A tiny percentage of people experience severe symptoms that can decrease their quality of life. These issues are seldom fatal.
Some of them are:
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Dental issues.
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Trouble in swallowing.
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Irreversible changes to the face, such as sagging lips or eyelids.
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Speech problems.
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Breathing issue.
How Is Tardive Dyskinesia Managed or Treated?
The medical professional may progressively lower the pharmaceutical dose. The patient may eventually quit taking medication. The doctor can recommend a different medication if they require continuous care.
These adjustments put an end to tardive dyskinesia symptoms for some patients. Medication adjustments should only be made while under the supervision of a healthcare expert. Some people's symptoms persist even after switching medications. The symptoms could become better and fade away with time. Very seldom do symptoms worsen.
The following therapies might be helpful if symptoms are persistent:
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Botulinum Toxin Injections - They temporarily stop facial nerve transmissions.
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There is just one medication that is authorized to treat the symptoms of movement disorders is Tetrabenazine.
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An implanted gadget called deep brain stimulation prevents erroneous nerve impulses from reaching the parts of the brain that regulate movement.
Conclusion
Antipsychotic drugs can cause tardive dyskinesia as a side effect. Schizophrenia and other mental illnesses are treated using these medications. Uncontrollably stiff and jerky facial and body movements are a symptom of tardive dyskinesia. Individuals may unintentionally wave their arms, blink their eyes, or protrude their tongues.
Antipsychotic medication does not always cause it. But in certain cases, tardive dyskinesia is irreversible. Therefore, promptly notify the doctor if an individual has uncontrollable movements. This helps in reducing the signs and symptoms. Speak with the healthcare professional if the individual has any risk factors that increase the likelihood of experiencing this issue. By using an alternative medication, an individual can avoid tardive dyskinesia.
