Tardive Dyskinesia: Risks and Concerns in Long-Term Medication Use

Irreversible tardive movement disorders

Psychiatry: Before bedtime: Leeyo (ESCITALOPRAM) 10mg*2 tablets, Lendormin 0.25mg*2 tablets, Eurodin 2mg*2 tablets, Lorazepam 0.5mg*4 tablets.
Dermatology: Before bedtime: Doxepin 25mg*2 tablets, Lyrica (pregabalin) 75mg*2 tablets, Xyzal 5mg (for skin itching that prevents sleep).
Metabolism: Metformin HCL 850mg.
Urology: Tamsulosin 0.2mg.
Gastroenterology: Medications to be taken before breakfast: Lansoprazole 30mg, Promethazine 3.84mg (Gastric protective film-coated tablet), after meals: KASCOAL.
Gastroenterology: Before lunch: Promethazine 3.84mg (Gastric protective film-coated tablet), after meals: KASCOAL, Dialicon.
Gastroenterology: Before dinner: Promethazine 3.84mg (Gastric protective film-coated tablet), after meals: KASCOAL, Dialicon.
All medications are taken long-term.

1.
Due to bloating, I sought treatment for a gastric ulcer at the gastroenterology department.
The ulcer healed after four months, but I have been taking Promethazine 3.84mg three times a day for five months.
According to the medication leaflet, it seems that this medication should not be taken for such a long duration.
My doctor still allowed me to take it for five months.
Is there a high probability that I will develop tardive dyskinesia in the future? This condition presents as involuntary movements in the face, tongue, and limbs, with potential irreversibility and severity?
2.
I am currently very concerned about the possibility of developing tardive dyskinesia.
If it occurs, does it mean that there is no treatment available for the rest of my life? I have already stopped taking this medication.
When is it likely that tardive dyskinesia will manifest? If it does, should I go to the hospital immediately? I am very worried.
Thank you, doctor, for your patient response.

ERICo, 30~39 year old female. Ask Date: 2020/07/30

Dr. Chen Shidian reply Gastroenterology and Hepatology

If there are side effects, they will occur shortly after taking the medication, so there's no need to worry.
If you're concerned, discuss switching medications with your doctor.

Reply Date: 2020/07/30

More Info

Tardive dyskinesia (TD) is a serious and often irreversible movement disorder that can occur as a side effect of long-term use of certain medications, particularly antipsychotics and other drugs that affect dopamine pathways in the brain. It is characterized by involuntary, repetitive movements, often involving the face, tongue, and limbs. The concern about developing TD is valid, especially for individuals who have been on long-term medication regimens.

1. Risk Factors for Tardive Dyskinesia: The risk of developing TD increases with the duration of medication use and the cumulative dose. Certain populations, such as the elderly, may be more susceptible. The medications you mentioned, particularly those affecting the central nervous system (CNS), can contribute to this risk. For instance, medications like escitalopram (Leeyo) and lorazepam can have CNS effects, but they are not typically associated with TD. However, if you have been prescribed medications like promethazine (Promeran), which is an antipsychotic, there is a potential risk for TD, especially with prolonged use.

2. Symptoms and Onset: Symptoms of TD can manifest as facial grimacing, tongue protrusion, lip smacking, and involuntary movements of the limbs. The onset can be gradual, and it may take months or even years after starting the medication for symptoms to appear. If you have stopped taking promethazine, the risk of developing TD may decrease, but it does not eliminate the possibility entirely. It is essential to monitor for any unusual movements or symptoms.

3. Management and Treatment: If you do develop symptoms of tardive dyskinesia, it is crucial to seek medical attention promptly. While there is no definitive cure for TD, early recognition and intervention can help manage symptoms. In some cases, switching to medications with a lower risk of TD or using medications specifically aimed at treating TD, such as valbenazine or deutetrabenazine, may be considered.
4. Long-Term Outlook: The fear of developing TD is understandable, but it is important to remember that not everyone who takes these medications will experience this side effect. Regular follow-ups with your healthcare provider can help monitor your condition and adjust your treatment plan as necessary. If you are concerned about the risk of TD, discussing alternative medications or strategies to minimize your risk with your doctor is advisable.

5. Psychological Impact: The anxiety surrounding the potential development of tardive dyskinesia can be distressing. It is essential to address these concerns with your healthcare provider, who can provide reassurance, education, and support. Cognitive-behavioral strategies may also help manage anxiety related to medication side effects.

In conclusion, while there is a risk of tardive dyskinesia associated with long-term medication use, particularly with certain classes of drugs, it is not a certainty. Monitoring, open communication with your healthcare provider, and being proactive about your treatment plan can help mitigate risks and address any concerns you may have. If you notice any involuntary movements or other unusual symptoms, do not hesitate to seek medical advice.

Similar Q&A

Understanding Tardive Dyskinesia: Risks and Concerns in Long-Term Medication

Dr. Yang Zhichao reply Gastroenterology and Hepatology
Hello Mr. LOV157, the medication insert does mention this situation, but the incidence is very low. There are also individuals who have been taking this medication long-term. If you have concerns, it would be best to discuss them with your prescribing physician, as this can help ...

Understanding Tardive Dyskinesia: Treatment Options and Self-Management

I have been taking Seroquel at Far Eastern Memorial Hospital's psychiatry department for a year, but I developed severe tardive dyskinesia (TD), characterized by grimacing, tongue protrusion, and lip smacking, along with constant lip movements. Therefore, I stopped the medic...

Dr. Wang Yaoting reply Psychiatry
Tardive dyskinesia (TD) may occur due to long-term use of antipsychotic medications, leading to hyperfunction of dopamine in the brain regions that control movement, which results in hyperkinetic movements in certain body parts and subsequently causes movement disorders. The prim...

Risks of Long-Term Use of ADHD Medications: A Patient's Perspective

What are the risks of long-term use of Concerta 36mg and Sertraline 10mg? I feel that the side effects include some restlessness and discomfort, as well as increased numbness in my legs. When the medication wears off, I experience some confusion and a tendency towards addiction, ...

Dr. Wu Enliang reply Psychiatry
Hello, I would like to ask about the long-term risks of taking 36mg of Concerta and 10mg of Sertraline. A: If taken as prescribed by a physician, long-term use should generally be fine, and there shouldn't be significant long-term risks. I think the side effects might includ...

Understanding Mesyrel: Uses, Long-term Effects, and Addiction Risks

Mesyrel (Mesoridazine) is an antipsychotic medication primarily used to treat schizophrenia and other psychotic disorders. Its effects include reducing symptoms such as hallucinations, delusions, and agitation. Long-term use of Mesyrel can lead to potential side effects, includ...

Dr. Hou Fangmin reply Pharmacology
Mesyrel selectively inhibits the reuptake of norepinephrine in the brain without producing central nervous system (CNS) stimulating effects. It is used for the treatment of depression, with or without anxiety. Common side effects associated with this class of medication include n...