VIDEO: What clinicians should know about causes, symptoms of tardive dyskinesia

Editor’s note: This is an automatically generated transcript, which has been slightly edited for clarity. Please notify iwaters@healio.com if there are concerns regarding accuracy of the transcription.

Tardive dyskinesia is an involuntary, repetitive, but irregular movement disorder. It is caused by dopamine receptor blockade that is related to either antipsychotics, as we know them right now, which are all postsynaptic dopamine blockers, or to metoclopramide, which is also an anti-dopaminergic medication used for gastric conditions.

What does it look like? Well, it's a choreiform movement that can be rapid, jerky and non-repetitive, and there are also athetoid movements, which are slow, sinuous and continual. And finally, there are some semi-rhythmic movements or stereotypies.

These movements mostly are located in the oral, lingual and buccal regions, and less often, movements can be present in the hands, legs, feet and torso. Very often we see tongue protrusion, puckering, chewing, grimacing. It can be quite severe and persistent, and have medical and psychosocial consequences that we'll get into.

But again, it's mostly associated with the use of dopamine receptor blocking agents, especially when you dose them high, and when there's also the equivalent of that which would be extrapyramidal side effects like Parkinson’s or akathisia. 

In terms of the pathophysiology, we're not really sure. We think that there might be some blockade-related autochthonous regulation of these dopamine receptors that then are more sensitive to endogenous dopamine. But there could also be issues with oxidative stress or inflammation.