Tardive Dyskinesia

Schizophrenia, Antipsychotics & Tardive Dyskinesia

Tardive dyskinesia occurs as a serious side effect of medications known as antipsychotics, or neuroleptics. These drugs, first developed in France in the early 1950s, were primarily used for the treatment of schizophrenia and other mental illnesses, although in recent years, similar drugs such as Reglan and Maxolon have been used to treat digestive disorders such as gastroesophageal reflux disease and diabetic gastroparesis (partial or complete paralysis of the stomach muscles).

Schizophrenia

Schizophrenia is a chronic and severe mental disorder that affects more than two million Americans. The illness causes patients to experience difficulty understanding the difference between real and unreal situations, think logically, manage emotions and behave normally in social situations.  Most patients will begin to demonstrate signs of schizophrenia as a teenager or during their early twenties.

The exact cause of schizophrenia is unknown, though researchers agree that the disorder likely occurs as a result of genetic and environmental factors.

Symptoms of schizophrenia may include:

  • Hallucinations
  • Disordered thinking
  • Disorganized behavior
  • Delusions
  • Loss of interest in normal activities
  • Withdrawal from social situations
  • Difficulty paying attention
  • Mood swings

Diagnosis and Treatment

When a doctor believes a patient may have schizophrenia, they will often request a copy of the patient's medical and psychiatric history. The doctor will then typically conduct a physical examination, followed by additional medical tests including physical diagnostic tests, such as blood tests and imaging tests, possibly including a CT scan or an MRI.

A psychological evaluation may also be conducted to assess a patient's mental health through observation and questioning.

Once diagnosed with schizophrenia, a patient will then begin treatment, often with medications and therapy. A treatment regimen is usually determined by an experienced psychiatrist.

Antipsychotics, Dopamine Antagonists and Side Effects

The medications used in the treatment of schizophrenia can cause serious side effects, which can make patients with schizophrenia reluctant to take them.

Neuroleptic, or antipsychotic, medications are associated with the development of various movement disorders that can range from mild to disabling. After taking dopamine antagonist medications, approximately 30 percent of patients begin to show symptoms of tardive dyskinesia, which primarily affects the muscles of the face and jaw, but may affect the extremities as well.

The best treatment for tardive dyskinesia is prevention. If detected early, those taking certain antipsychotics may be able to avoid developing additional symptoms, and those already manifested may disappear, although this is not the case for every patient. The use of newer atypical medications has managed to reduce the risk of schizophrenic patients developing tardive dyskinesia. However, it appears as though these medications do not prevent such symptoms, but merely delay their onset. Clozapine is currently considered one of the most effective medications for schizophrenia today, but has been relegated for use only after typical and atypical neuroleptics have failed to achieve the desired result due to other potentially serious side effects.