Tardive Dyskinesia

Written by Alicia Racelis, PhD
Medically Reviewed by Brunilda Nazario, MD on March 17, 2025
6 min read

Tardive dyskinesia (TD) is an involuntary movement condition, meaning you can't control your movements. "Tardive" means late, and "dyskinesia" means uncontrolled movements. It's often a side effect of medication that blocks dopamine in your brain. That's a brain chemical to help your nerves and body function, including movement. 

Your medicine may not cause TD symptoms for months or even years. So it can be hard to diagnose. But if you have TD, you can get stiff, jerky movements in your face and body that you can't control. You might blink your eyes, stick out your tongue, or wave your arms without meaning to do so.

Some antipsychotic and antiemetic medicines can cause tardive dyskinesia. Antipsychotics treat mental health problems (like schizophrenia ) to help you know what's real or not. Antiemetics help you stop vomiting and ease nausea.

Not everyone who takes these medications will get TD. But if it happens, TD can sometimes be lasting. So if you have uncontrollable movements, let your doctor know right away. Early diagnosis can ease your symptoms. Your doctor can help you:

  • Lower the dose.
  • Add another medication to prevent the movements.
  • Switch you to a different medicine.

Tardive dyskinesia can be different for everyone. It's a complex health condition causing stiff, uncontrolled, repeated movement. TD can affect the muscles in your face (orofacial dyskinesia) or your arms and legs (dyskinesia of the limbs).

Orofacial dyskinesia or oro-bucco-lingual dyskinesia. These are uncontrolled movements in your face — namely your lips, jaw, or tongue. The muscles in your face might cause you to:

  • Stick out your tongue without trying
  • Blink your eyes fast or twitch
  • Chew
  • Smack or pucker your lips
  • Puff out your cheeks
  • Frown
  • Grunt

Dyskinesia of the limbs. It can affect your arms, legs, fingers, and toes. TD can cause your muscles to:

  • Wiggle your fingers, sometimes called "piano-playing"
  • Tap your feet
  • Flap your arms
  • Cross your legs repeatedly
  • Shrug your shoulders
  • Twist or stretch your neck
  • Thrust out your pelvis
  • Sway from side to side

These movements can be fast or slow. You may find it hard to work and stay active.

Sometimes antipsychotic medicine can cause your TD. These medications treat schizophrenia, bipolar disorder, and other brain conditions. Doctors also call them neuroleptic medicines. They lower or calm your nerve function.

Because these medicines can block dopamine, your nerve cells may not talk to each other as well. Nerve cells help you move your muscles. So if dopamine drops too low, your movements can be jerky or out of control.

Symptoms may not show up for three months or more after taking these medications. But there have been rare cases of TD after a single dose. Older versions of antipsychotics are more likely to cause this issue than newer ones. Some studies find the same risk from both types, though.

Antipsychotic medications that can cause TD include:

  • Haloperidol (Haldol)
  • Fluphenazine
  • Olanzapine (Zyprexa)
  • Risperidone (Risperdal)

The longer you take these medicines, the higher your chances of getting TD.

Some medicines that treat nausea, reflux, and other stomach problems (antiemetics) can also cause TD. You might notice symptoms after three months or more. Some of these medicines include:

  • Metoclopramide (Reglan)
  • Prochlorperazine (Compazine)

Risk factors for tardive dyskinesia

Research is ongoing, but some genetic factors can also raise your risk for TD. And you're more likely to get it if you:

  • Are a woman, especially if you've gone through menopause
  • Are over 40 years of age, but the risk gets higher over age 65
  • Have other medical conditions such as dementia, diabetes, or intellectual disability
  • Have a mental health condition, such as schizophrenia or bipolar disorder
  • Are a Black American
  • Have a history of substance or alcohol abuse

The longer you take a dopamine-blocking medication, such as an antipsychotic, the higher your risk of developing TD.

TD can be hard to diagnose. Symptoms might not appear for months or years after you take the medicine. Or you might first notice the movements after you've already stopped the medicine. The timing can make it hard to know which medicine caused your symptoms.

Abnormal Involuntary Movement Scale (AIMS). If you take medicine for mental health conditions, your doctor should check you for TD symptoms at least once a year. After reviewing your medical history, they can give you a physical exam called the Abnormal Involuntary Movement Scale. The AIMS helps them rate any abnormal movements.

They can also do tests to see if you have another medical condition that may cause your movements like:

To rule out these conditions, you may get:

  • Neurological exams to check your thinking, muscle tone, and coordination
  • Blood tests
  • Imaging scans of your brain, such as a CT or MRI scan

Clinician's Tardive Inventory (CTI) and Tardive Dyskinesia Impact Scale (TDIS). Research is ongoing, but the CTI looks at how your eyes, legs, and arms move. It works out how often they happen and asks about other parts of your body, too. The test also asks you how TD affects your social and daily activity.

The TDIS lets you answer questions about TD. You'll likely talk about your social, physical, and emotional health. These tests help your doctor figure out the best treatment for your TD.

The goal is to prevent your TD symptoms. When your doctor gives you a new medication, ask about its side effects. If you don't understand something, ask questions. The benefits of the drug should outweigh its risks.

If you have movement problems, tell your doctor. But don't stop taking your medicine on your own. Your doctor can take you off your medication slowly. They'll help you decide if it's causing your symptoms and lower your dose.

Switching or changing the dose. You might need to switch to a newer medication. Some medicines may be less likely to cause TD. But no matter which medication you take, your doctor will track your progress. They'll also check for signs of TD.

To help lessen your tardive dyskinesia symptoms, your doctor may also change your dose. Follow their instructions carefully. It may take several weeks to see improvements. Your symptoms may get worse before they get better. And they may add back medicine for a short time before lowering it again. 

Adding medication. Sometimes, you'll start taking another medication, too. If you have mild symptoms, your doctor may give you benzodiazepines. These sedatives can make you sleepy and help ease your TD symptoms. The medicines that can treat more serious symptoms include:

  • Deutetrabenazine (Austedo)
  • Valbenazine (Ingrezza)

Your doctor may also use an off-label medicine called tetrabenazine (Xenazine). It can help control the amount of dopamine in your brain to help you move better. These medications can sometimes cause drowsiness, too. If you have Huntington's disease, deutetrabenazine may also cause depression.

Taking supplements. There's no proof that natural remedies can treat your symptoms, but some might help with movements. They include:

Talk to your doctor before you take any supplements for your symptoms.

Botulinum toxin (BOTOX). If you have tardive dyskinesia in only one part of your body, your doctor might suggest botulinum toxin (BOTOX). The toxin can block your nerve signals to stop the muscles from twitching.

Deep brain stimulation (DBS). If your TD symptoms are constant, your doctor might also suggest deep brain stimulation (DBS). DBS can help Parkinson's and may also help ease TD symptoms. If other TD treatments aren't working, ask your doctor about your options.

Usually, tardive dyskinesia is a long-term medical condition. But your TD symptoms can go into remission, meaning your symptoms can go away. If you're taking an antipsychotic or antiemetic medication, watch for TD signs.

Tell your doctor right away if you notice any uncontrolled movements. Early diagnosis gives you the best chance for treatment and remission. Your doctor can help you decide on the best treatment option.

How to reverse tardive dyskinesia​

Although potentially permanent, you can do some things to help prevent or lower your chances for tardive dyskinesia. Monitor your symptoms for early diagnosis. Watch out for any uncontrollable movements and tell your doctor right away. Your doctor can help identify the cause of your TD symptoms. With treatment, TD symptoms can go into remission (a period without symptoms).

Is tardive dyskinesia permanent?

Tardive dyskinesia is potentially a permanent condition. But early diagnosis and treatment can mean remission. Remission is when your TD symptoms go away or lessen. Your doctor can help you decide on the best treatment for your TD.

What kind of doctor treats tardive dyskinesia? 

Most movement disorder specialists are doctors who treat brain problems. This can include a neurologist (a doctor who treats your brain, spinal cord, and nerves) or a psychiatrist (who specializes in mental health).