How to manage tardive dyskinesia with Parkinson's symptoms?

Question

Hello doctor,

I am asking about my dad, who is 70 and has tardive dyskinesia after years of psychiatric treatment. The involuntary mouth and facial movements have been present for a while, but lately he has also developed slower walking, stiffness, and tremor that look a bit Parkinson's-like to us.

It is getting harder for him to tell which symptoms come from what, and daily tasks are becoming more frustrating. His psychiatrist mentioned a medication review, but we are still confused about whether these symptoms overlap or point to something new entirely.

For older adults dealing with tardive dyskinesia plus Parkinson-like symptoms, what treatments or medication changes usually help improve function and quality of life?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Mouth and head tremors after years of antipsychotic treatment are consistent with tardive dyskinesia. Hand tremors in tardive dyskinesia are usually coarse, may be asymmetrical, and most commonly affect the wrist region.

Slower walking, stiffness, and tremors can be caused by Parkinson's disease, especially at 70 years of age. These symptoms can also be caused by antipsychotic medications as a manifestation of extrapyramidal side effects, known as pseudoparkinsonism.

Hand tremors in Parkinson's disease are typically asymmetrical, pill-rolling in nature, present at rest, and have a frequency of three to six Hertz. In contrast, pseudoparkinsonian tremors are usually more symmetrical and fine and are more noticeable when the hands are held outstretched with fingers apart.

The management approach is different for tardive dyskinesia and Parkinson's disease compared to tardive dyskinesia with pseudoparkinsonism syndrome.

Be assured, this is a manageable condition. Kindly revert back with more details about tremors, gait, current treatment plan and duration, diagnosis for which antipsychotics were prescribed, and current symptoms.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.