I am 48, male. How to manage my involuntary movements?

Question

Hello doctor,

I am a 48-year-old man who has been taking antipsychotic medication for schizophrenia for about eight years, and over the past year, I have developed some really disturbing involuntary movements that I cannot control. My tongue keeps moving around in my mouth on its own, sometimes sticking out or making chewing motions, even when I am not eating. My lips pucker and smack involuntarily, and I make facial grimaces that I am not aware of until someone points them out to me. I have also started having jerky movements in my arms and hands, and sometimes my fingers move in repetitive patterns like I am playing the piano.

These movements happen when I am awake and seem to get worse when I am stressed or tired, but I cannot make them stop, no matter how hard I try. People stare at me in public, and it is affecting my confidence and social interactions. My psychiatrist mentioned that this might be related to my long-term medication use, but I am afraid to stop taking my antipsychotic because I know I need it for my mental health.

Could these involuntary movements be caused by my psychiatric medication, and why are they getting worse over time? Is there a connection between how long I have been taking antipsychotics and these uncontrollable facial and body movements?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Thank you for describing your symptoms in such detail. It helps me understand what you are experiencing. Based on what you have shared, it is most likely due to a condition called tardive dyskinesia (TD).

TD is a well-known side effect of long-term use of antipsychotic medications. It causes involuntary, repetitive movements involving the tongue, lips, mouth, jaw, fingers, and arms (just like how you have described, like playing a piano). It can worsen over time, especially with the continued use of certain antipsychotics.

The reason behind it is a dopamine imbalance. Antipsychotic drugs alter dopamine signaling in the brain over time. This imbalance leads to these uncontrolled movements, more so due to prolonged use.

I would like to suggest a few things:

Do not stop your antipsychotic drugs abruptly, as it may worsen psychiatric symptoms. Kindly consult your psychiatrist about switching over to other antipsychotics with which these side effects are lower.
Drugs like Valbenazine are used for treating tardive dyskinesia. A neurophysician or movement disorder specialist can assess the severity of TD and help you with treatment.
Lifestyle changes such as adequate sleep, breathing exercises, and yoga can be beneficial. Avoid alcohol or caffeine.

Yes, you are experiencing TD due to long-term antipsychotic use, and you are not alone. It is common in people who have been taking antipsychotics for a long time. There are effective drugs available that can help manage these movements. You have done the right thing by reaching out. You deserve relief without compromising your mental health.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.