Tardive Dyskinesia: Treatment Options and Self-Management

Delayed onset motor difficulties (TD)

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 medication.
It has been six months since I discontinued the medication, but the symptoms remain severe.
The psychiatrist told me there is no medication to treat it.
I am afraid to go out to get a haircut and can only stay at home, and I am completely unable to work.

1.
Are there any medications available to treat tardive dyskinesia? My symptoms are severe, with grimacing and constant lip movements, which even affect my ability to eat.
Is it true that there are no medications available for treatment, or will I recover if I stay off the medication longer?
2.
I found online that Tetrabenazine may help treat TD.
Why hasn't my doctor prescribed it for me? Is it possible that this medication is not suitable for my symptoms?
3.
Is there any way for tardive dyskinesia to self-resolve? Thank you, doctor, for your answers.

ERIC, 30~39 year old female. Ask Date: 2022/02/02

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 primary principle of management is "preventing the occurrence of TD." If TD has already developed, most cases can improve or partially alleviate after changing medications, although a minority may persist for a long time.
Currently, there are several medications (most of which are dopamine-modulating agents) or deep brain stimulation that may be helpful, but there is no universally effective medication.
In severe cases, local injections of botulinum toxin may be considered.
All of the above requires professional evaluation by a physician.
I hope this answers your question :)

Reply Date: 2022/02/02

More Info

Tardive Dyskinesia (TD) is a complex and often distressing condition that arises primarily as a side effect of long-term use of antipsychotic medications. It manifests as involuntary, repetitive movements, often affecting the face, lips, and tongue, which can severely impact a person's quality of life. Your experience of severe facial movements and the inability to perform daily activities is understandably challenging and distressing.

1. Treatment Options for Tardive Dyskinesia
Currently, there is no universally effective treatment for TD, and the management of this condition can be quite complex. While some patients may experience spontaneous improvement after discontinuing the offending medication, others may continue to experience symptoms long after stopping the medication. The duration of symptoms can vary significantly from person to person.

There are several treatment options available that may help alleviate symptoms of TD:
- Medications: Tetrabenazine is one of the medications that has been used to treat TD. It works by depleting dopamine, which can help reduce involuntary movements. However, it is important to note that not all patients respond to Tetrabenazine, and it may not be suitable for everyone, especially if there are contraindications or potential side effects. Other medications, such as valbenazine and deutetrabenazine, have also been approved for the treatment of TD and may be worth discussing with your healthcare provider.

- Botulinum Toxin Injections: In some cases, botulinum toxin (Botox) injections can be used to target specific muscle groups that are overactive, providing temporary relief from involuntary movements.

- Deep Brain Stimulation (DBS): For severe cases of TD that do not respond to medication, DBS may be considered. This is a surgical procedure that involves implanting electrodes in specific areas of the brain to help regulate abnormal movements.

2. The Role of Tetrabenazine
You mentioned that you found information about Tetrabenazine and its potential use in treating TD. While it can be effective for some patients, the decision to prescribe it depends on various factors, including your overall health, the severity of your symptoms, and any other medications you may be taking. It is essential to have an open discussion with your psychiatrist about your symptoms and the potential benefits and risks of starting Tetrabenazine or any other treatment.

3. Self-Management Strategies
While pharmacological treatments are essential, there are also self-management strategies that may help improve your quality of life:
- Support Groups: Connecting with others who have experienced TD can provide emotional support and practical advice. While you mentioned feeling isolated, seeking out local or online support groups can help you feel less alone.

- Therapeutic Techniques: Engaging in therapies such as cognitive-behavioral therapy (CBT) can help you cope with the emotional and psychological aspects of living with TD. Additionally, occupational therapy may assist you in developing strategies to manage daily tasks more effectively.

- Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, yoga, or tai chi can help reduce stress and improve overall well-being, which may indirectly help manage symptoms.

- Diet and Nutrition: Maintaining a healthy diet and staying hydrated can support overall health and may help improve your energy levels and mood.

Conclusion
In conclusion, while there is no definitive cure for Tardive Dyskinesia, there are treatment options available that may help manage symptoms. It is crucial to work closely with your healthcare provider to explore these options and find a tailored approach that suits your needs. Additionally, self-management strategies can play a significant role in improving your quality of life. Remember, you are not alone in this journey, and seeking support from healthcare professionals and peers can make a significant difference.

Similar Q&A

Effective Treatment Options for Tourette Syndrome: A Comprehensive Guide

Treatment methods for Tourette syndrome.

Dr. Zhu Shaoying reply Rare Disease
Hello: First, family members, friends, teachers, and colleagues of patients with Tourette syndrome must have a correct understanding of the condition, as the symptoms of Tourette syndrome are involuntary and cannot be controlled. When it comes to pharmacological treatment for Tou...

Managing ADHD and OCD: Seeking Effective Treatment Options

Hello, doctor. I was diagnosed with ADHD when I was 4 to 5 years old. Throughout the years, I have taken antihistamines, Strattera, Ritalin, and recently, I have also tried Sertraline. I experienced side effects and felt that the medications did not have much effect, so I did not...

Dr. Song Chengxian reply Psychiatry
Hello: Your current condition, including obsessive symptoms, indicates that you feel your executive function is poor and you are experiencing a sense of helplessness. I recommend that in addition to medication treatment, you take some time to arrange for cognitive-behavioral ther...

Understanding Tardive Dyskinesia: Risks, Symptoms, and Treatment Options

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 prev...

Dr. Jiang Junyi reply Neurology
Hello: Generally speaking, extrapyramidal symptoms (EPS) are more common in patients using Primperan or certain antipsychotic medications, and are somewhat related to individual constitution. Children and the elderly are also more susceptible. Essentially, to enhance intestinal m...

Managing ADHD in Children with Autism: Medication and Behavioral Strategies

Dear Dr. Liang, My child has severe multiple disabilities and is diagnosed with autism. Since starting junior high school (currently in the first year), his condition has become quite unstable. He is currently taking the following medications: DEPAKINE (500 mg) one tablet in the...

Dr. Liang Sunyuan reply Psychiatry
Hello: Caring for a child with severe autism is a long and challenging journey, so please take care of yourself first. The symptoms and behaviors of your child are not anyone's fault. You have clearly described your child's condition and the efforts you have made in the...