How to manage tardive dyskinesia and depression in women?

Question

Hello doctor,

I am a 44-year-old woman currently taking antipsychotic medication for bipolar depression. Recently, I have started experiencing involuntary jaw movements and lip smacking. My psychiatrist mentioned that this could be tardive dyskinesia. I am wondering whether this condition is permanent, if it can worsen over time, and whether there are treatment options available to reduce or reverse the symptoms, particularly for women.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

I am genuinely regretful that you are experiencing this.

Tardive dyskinesia (TD) is a movement disorder that can develop as a result of the long-term use of specific antipsychotic medications. The repetitive mandible movements and lip smacking you are describing are indeed indicative of TD.

TD is a condition that can result from chronic blockade of dopamine receptors in the brain, which can occur with both older and some newer antipsychotics. This occurs when the receptors become excessively sensitive. The risk of developing the condition increases with age and the duration of treatment, and it is more prevalent in women.

TD may occasionally resolve, particularly if it is detected early and the medication responsible for it is reduced or altered. However, if left untreated, it may persist or worsen over time. Although some individuals experience partial or complete improvement with appropriate intervention, it is considered potentially permanent.

FDA-approved medications are now available for the treatment of TD. Valbenazine and deutetrabenazine (Austedo) are the two primary options. These medications operate by regulating dopamine activity in the brain and have been demonstrated to significantly reduce involuntary movements. Many women benefit from these medications, which are generally well tolerated, despite their high cost.

Switching to an antipsychotic with a lower risk of TD, such as Quetiapine or Clozapine, may also be considered in certain circumstances. However, this must be done with great care to prevent mood instability.

It would be beneficial if you could provide your current medication inventory for a thorough review. Additionally, you should report any symptoms that worsen, such as those affecting the tongue, extremities, or voice, as soon as possible. The more promptly TD is identified and managed, the more favorable the results are.

You are unquestionably taking the appropriate course of action by being proactive. Numerous individuals obtain substantial alleviation from these symptoms when they implement an appropriate treatment regimen. I trust that this information is beneficial.

I hope this helps.

Thank you.