Yes. Tardive dyskinesia symptoms can be linked to certain medicines, particularly medicines that affect dopamine signalling in the brain. The condition causes repetitive or involuntary movements that a person cannot fully control. Symptoms often affect the mouth, tongue and face, but they can also involve the arms, legs, fingers or trunk.
Tardive dyskinesia (TD) is most strongly associated with antipsychotic medicines, especially after longer-term treatment, although it can sometimes develop sooner. New or unexplained involuntary movements should be discussed with a doctor or pharmacist rather than diagnosed at home.
If you are taking medicine for a mental health condition, see our Mental Health Medication Side Effects hub and guide to antipsychotic movement side effects for related information.
Do not stop or change a prescribed medicine on your own because you are worried about tardive dyskinesia.Sudden changes can create other health risks. Contact the healthcare professional who prescribed the medicine so that your symptoms and treatment can be reviewed safely.
How tardive Dyskinesia Symptoms can be linked to medicines or supplements
Tardive dyskinesia is a movement disorder characterised by involuntary, repetitive movements. The word “tardive” refers to delayed onset, while “dyskinesia” means abnormal movement.
Typical tardive dyskinesia symptoms can include:
- repeated lip smacking or puckering
- chewing movements when you are not eating
- tongue thrusting or repeatedly sticking out the tongue
- facial grimacing
- rapid or frequent blinking
- unusual jaw movements
- repetitive finger movements
- jerking, twisting or uncontrolled movements of the arms or legs
- rocking or repetitive movements involving the body or pelvis.
MedlinePlus notes that TD often develops after a person has taken an implicated medicine for months or years, although it may occasionally appear after a shorter period.
The movements can range from subtle to much more noticeable. Another person may sometimes notice them before the person experiencing them does.
Not every tremor, twitch, restless movement or facial movement is tardive dyskinesia. Other medicine-related movement problems and neurological conditions can produce similar symptoms. A healthcare professional therefore needs to consider the type of movement, the medicines being used, when the symptoms began and other possible causes.
There is much stronger evidence linking tardive dyskinesia to particular medicines than to ordinary nutritional or herbal supplements. If symptoms started after using a supplement, complementary medicine or other health product, tell your doctor or pharmacist exactly what you have been taking. Do not assume that the product is either responsible or harmless without an appropriate assessment.
Medicines and product categories that may be associated with this symptom
Antipsychotic medicines
Antipsychotics are the medicine group most clearly associated with tardive dyskinesia. They are used for conditions including schizophrenia, bipolar disorder and other psychiatric illnesses.
Older, first-generation antipsychotics have historically been associated with a higher risk of TD. Newer antipsychotics generally carry a lower risk, but the risk has not been eliminated.
This does not mean that everyone taking an antipsychotic will develop tardive dyskinesia. Risk differs between medicines and individuals and may be influenced by treatment duration and other health factors.
If you notice unusual movements while taking an antipsychotic, arrange a medication review. The prescriber can determine whether the movements may represent tardive dyskinesia or another type of antipsychotic movement side effect.
Metoclopramide
Tardive dyskinesia is also an important recognised risk of metoclopramide, a medicine used for certain gastrointestinal problems and for nausea or vomiting in some circumstances.
Current MedlinePlus information warns that metoclopramide can cause uncontrollable movements, particularly involving the face, and that tardive dyskinesia may sometimes persist even after the medicine is discontinued.
Anyone taking metoclopramide who develops movements such as repeated lip smacking, chewing, tongue movements, unusual blinking or shaking of the arms or legs should contact their doctor promptly.
Other medicines
Other medicines have also been reported in association with tardive or dyskinetic movements. However, the strength of the association is not the same for every medicine.
Because several medicines can cause different types of abnormal movement, do not identify the cause from a medicine list alone. Give your doctor or pharmacist a complete list of everything you use, including prescription medicines, pharmacy medicines, complementary products and supplements.
For broader information about possible reactions, see our guide to medication side effects.
Red flags: when this symptom may need urgent medical attention
New involuntary movements deserve medical attention, but tardive dyskinesia itself does not automatically mean that you are experiencing a medical emergency.
Contact the prescribing doctor or another healthcare professional promptly if:
- new involuntary movements have appeared or are becoming more noticeable
- movements are interfering with eating, speaking, walking or everyday activities
- symptoms are progressing rapidly
- you have recently started, stopped or changed the dose of a medicine associated with movement problems
- you are unsure whether the movements could be a medicine side effect.
Seek immediate medical help if abnormal movements occur together with severe symptoms such as difficulty breathing or swallowing, collapse or fainting, seizures, severe confusion, or swelling of the face or throat.
People taking dopamine-affecting medicines can also experience serious adverse reactions that are different from tardive dyskinesia. For example, fever accompanied by severe muscle stiffness, confusion, heavy sweating or changes in heartbeat requires urgent assessment. Similar serious warning symptoms are included in current medicine safety information for metoclopramide.
If you cannot tell whether a new symptom is urgent, contact a healthcare professional or emergency service rather than trying to diagnose the movement yourself.
What to track before speaking to a doctor or pharmacist
Clear information about what is happening can help a healthcare professional assess the symptoms.
Note what the movement looks like
Write down:
- which part of the body is affected
- whether the movement happens repeatedly
- whether you can temporarily control it
- whether it happens while resting, moving or both
- whether it interferes with eating, speaking, sleeping, walking or other activities.
If appropriate and the affected person agrees, a short video of the movement may also help a clinician understand what you are describing.
Record when it started
Try to establish:
- when you first noticed the movement
- whether it appeared suddenly or gradually
- whether it is becoming more frequent
- whether anything seems to make it better or worse.
Make a complete medicine list
Include:
- all prescription medicines
- over-the-counter pharmacy medicines
- medicines taken only occasionally
- vitamins and supplements
- herbal or complementary products.
Include the dose if you know it and how long you have been taking each product.
Also mention recent medicine changes, including dose increases, reductions or medicines that have recently been discontinued. This timing can be important because tardive dyskinesia is a delayed movement disorder and symptoms do not necessarily begin immediately after the first dose of a medicine.
What not to do without medical advice
Do not suddenly stop prescribed medication
If you suspect tardive dyskinesia, it may seem logical to immediately stop the medicine you think is responsible. That is not always safe.
For some medicines, stopping abruptly can cause withdrawal effects or allow the condition being treated to worsen. The appropriate response depends on the medicine, your medical history and the severity of the movements.
A clinician may decide that treatment needs to be changed, but that decision should be made as part of a medical assessment. MedlinePlus notes that when TD is diagnosed, a healthcare provider may consider gradually stopping or changing the responsible medicine.
Do not change the dose yourself
Taking less medicine, skipping doses or changing the timing without advice can make treatment unpredictable and may not resolve the movement problem.
Do not start another medicine or supplement to “cancel out” the movements
Tardive dyskinesia requires proper assessment. Trying another medicine, herbal remedy or supplement without medical guidance could introduce interactions or additional side effects.
A doctor may have specific treatment options available when TD is confirmed, but treatment depends on the individual situation.
Related side-effect guides and reporting options in South Africa
If you think your symptoms may be connected to a medicine, start by speaking to your doctor, pharmacist or other healthcare professional. They can assess whether the symptoms may represent tardive dyskinesia, another medicine-related movement disorder or a condition unrelated to your treatment.
You can also explore the side effect symptoms A-Z for information about other symptoms that may occur with medicines.
Can a suspected side effect be reported in South Africa?
Yes. The South African Health Products Regulatory Authority (SAHPRA) accepts reports of suspected adverse effects from consumers as well as healthcare professionals.
SAHPRA advises consumers who are concerned about a suspected medicine side effect to contact a healthcare professional for advice. Consumers may also submit an adverse-event report themselves through the available reporting channels.
See our guide on how to report side effects in South Africa.
Reporting a suspected reaction does not prove that the medicine caused it. Pharmacovigilance reports help regulators monitor safety signals and investigate possible medicine-related risks.
Frequently asked questions about tardive dyskinesia symptoms
Is tardive dyskinesia a common side effect?
The likelihood depends on the medicine, duration of treatment and individual risk factors. Tardive dyskinesia has historically been more strongly associated with older antipsychotic medicines. Newer antipsychotics generally have a lower risk, but they can still be associated with TD.
Rather than trying to estimate your personal risk from general statistics, speak to your doctor or pharmacist about the specific medicine you are taking.
How long can tardive dyskinesia symptoms last?
The course varies. In some people symptoms may improve after the responsible medicine is appropriately managed, while in others the movements can persist. MedlinePlus notes that tardive dyskinesia can sometimes become permanent, including after the implicated medicine has been stopped.
This is one reason new involuntary movements should be assessed rather than ignored.
Should I stop my medicine if I develop unusual movements?
Do not stop a prescription medicine without medical advice unless an emergency healthcare professional instructs you to do so.
Contact your prescriber promptly and describe the movements. Your doctor can assess whether your treatment needs to be changed and how to make any change safely.
When should I seek medical help?
Arrange a medical review promptly for new, persistent or worsening involuntary movements, particularly if you take an antipsychotic, metoclopramide or another medicine known to affect movement.
Seek immediate medical help if the symptoms occur with trouble breathing or swallowing, severe swelling, collapse, seizures, severe confusion or another rapidly developing serious symptom.
This information is for general education and does not diagnose tardive dyskinesia or replace advice from a doctor or pharmacist. If you develop unexplained involuntary movements while taking medication, have your symptoms and medicines reviewed by a healthcare professional.