Tardive Dyskinesia Risk Factors

The cause of tardive dyskinesia (TD) is still very much unknown to doctors and researchers, despite the fact that many of them have been studying the disorder for years. Technically speaking, most researchers believe the disorder is caused by the long-term blocking of dopamine D2 receptors, which occurs with all antipsychotics and some other medications that act on the brain. The blocking of dopamine D2 receptors is believed to cause the random and spontaneous movements and muscle spasms in different parts of the body, particularly in the facial region, that are associated with TD.

Medications that Increase the Risk of TD

One of the biggest risk factors for developing tardive dyskinesia is long-term use of older antipsychotic drugs or extended use of other medications that have proven similarly harmful, including metoclopramide drugs such as Reglan and its generic equivalents.

Long-term use of metoclopramide medications is generally defined as longer than the recommended 90 days. These drugs now carry a black box warning which states that the risk of tardive dyskinesia increases with the length of metoclopramide therapy and with use of high doses.

Additional Risk Factors

There are a number of additional factors that play a role in increasing the likelihood that a patient will develop TD, including:

Age – Statistics from the National Alliance on Mental Illness show that the elderly are much more likely to develop tardive dyskinesia than those in a younger age category. Part of the reason for this may be that the drugs which cause the disorder are more frequently prescribed to older individuals, such as those drugs used in the treatment of gastrointestinal problems, including heartburn, nausea, vomiting, gastric acid reflux, and gastroparesis in diabetic patients. One study published in the American Journal of Psychiatry in 1998 indicated that patients who are over the age of 50 and taking typical antipsychotics are three to five times more likely to develop TD.
Gender – Post-menopausal females account for the group of individuals most often diagnosed with the disorder. Again, part of the reason for this may be that they are the group most likely to be given the drug for long-term use.
Mental retardation – Individuals who are mentally handicapped or who suffer from some sort of organic brain dysfunction or atrophy are more likely to develop the disorder than those with healthy brains.
Substance abuse – People with a history of alcoholism or drug abuse seem to be more apt to develop the disorder when prescribed the drugs associated with TD.

Sources

Free information packet on Tardive Dyskinesia

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