Tardive dyskinesia involves repetitive, involuntary movements that may affect the mouth, tongue, face, trunk, or limbs. It can develop after exposure to dopamine receptor blocking medicines and may persist even after the medicine is changed or stopped. Treatment is individualized according to symptom severity, underlying conditions, and the need for ongoing medications.
One important part of treatment is reviewing medicines that may contribute to tardive dyskinesia. A healthcare professional may consider reducing the dose, discontinuing a suspected medicine, or changing treatment when clinically appropriate. However, stopping an antipsychotic medicine suddenly can cause problems, and medication changes should be supervised by a healthcare professional.
VMAT2 inhibitors are among the principal medication options specifically used for tardive dyskinesia. Valbenazine is a VMAT2 inhibitor approved by the FDA for treating tardive dyskinesia in adults. Deutetrabenazine is another VMAT2 inhibitor available for tardive dyskinesia treatment. These medicines work by modifying the handling and release of certain neurotransmitters involved in movement.
Common treatment considerations include:
Not every person with tardive dyskinesia requires the same treatment. Healthcare professionals may use clinical assessments and movement-rating tools to monitor symptoms over time. The Abnormal Involuntary Movement Scale is one tool used to evaluate the severity of involuntary movements.
Other treatments have been studied, including clonazepam, amantadine, tetrabenazine, botulinum toxin injections, and deep brain stimulation. However, the strength of evidence varies between these approaches, and some are used only in selected circumstances. The American Academy of Neurology has noted that evidence for several treatments is limited or insufficient.
Important aspects of ongoing management include:
Treatment decisions depend on the individual's symptoms, other medical conditions, current medicines, and treatment goals. There is no single approach that is appropriate for everyone. Early recognition and regular monitoring can help healthcare professionals determine whether treatment changes may be appropriate. Information about available therapies can support informed discussions between patients and healthcare professionals, but prescribed medicines should not be started, stopped, or adjusted without professional guidance.