spotlight on tardive dyskinesia, a movement disorder
Here at Planet Thrive, we are big proponents of using natural, non-invasive approaches like dietary change and lifestyle modifications to shift the ill body toward a healthier equilibrium. Although we are not against using pharmaceuticals in any given situation, we certainly believe that they should not be the first recourse to managing a health condition. One reason is that they can cause a lifelong addiction or dependence on the drug without addressing the root cause of the illness – merely offering a bandaid solution that ultimately drains the bank account of the sufferer while padding the pockets of Big Pharma.
Another reason we are cautious of prescription medications is that pharmaceuticals can be very hard on the liver, which must process all “xenobiotics,” and can cause many secondary conditions and side effects that are even worse than what you turned to the medication for in the first place. Sometimes these new conditions are permanent, as in the case of tardive dyskinesia, a movement disorder that can cause involuntary movements such as facial grimacing, jaw swinging, repetitive chewing, and tongue thrusting, as a result of taking certain medications including neuroleptics.
Tardive Dyskinesia (TD) Center website
From the Tardive Dyskinesia Center:
“Tardive dyskinesia is a result of damage to the bodily systems that process dopamine, and is typically caused by exposure to certain prescription medications – including Reglan. Tardive dyskinesia causes victims to suffer from involuntary, repetitive movements which often continue after the drug is no longer used.
Tardive dyskinesia symptoms which are irreversible and incurable, mimic those of Parkinson’s disease. The best treatment for tardive dyskinesia appears to be prevention although there are some natural ways to manage your symptoms.
In one study spanning two decades, 60,000 patients under the care of 80 psychiatrists who were treating their patients with typical anti-psychotic medications while concurrently administering high doses of vitamin supplements. These supplements included Vitamin C, Niacin, Vitamin B6, and Vitamin E. Significantly, only 34 out of the 60,000 patients developed symptoms of tardive dyskinesia.
Another tardive dyskinesia treatment relies on dopamine agonists – medications that activate receptors where dopamine is not present. These are used in the treatment of Parkinson’s disease. Amine-depleting medications actually reduce the levels of dopamine in the brain as well as serotonin. The most effective of these appears to be tetrabenazine, which was approved for use in the U.S. in August of 2008 for the treatment of Huntington’s disease.”
Bottom line, we all need to consciously eschew the pill-popping messages we get bombarded with in our culture and start taking full responsibility for our own health. No looking to Big Pharma to make all our symptoms go away quick, then sticking our heads back down in the sand because everything is okay now. Time to start growing, cooking and/or preparing our own organic food, eliminating chemicals from our homes and lifestyles, and pursuing the careers, people, and lives that make us happy.
I know – I make it sound easy when in reality it is quite difficult to achieve, especially if you are in the middle of the rat race with a family to feed and a mortgage to pay, or suffering from an extremely challenging and chronic pain disorder. But change has to start somewhere, why not with you? Why not do the hard work now, starting with one small simple step and building up, before you are the next victim of a prescription drug “side effect”?
All I know is I heard today about a young man who had turned to Zoloft several years ago to treat depression and now suffers from Parkinson-like tremors. Permanent? I don’t know. But it makes me very sad to hear about this, knowing that there are a lot of other natural options for treating depression that he could have tried first, had he known about them.
Sure, there are situations that are best treated with medication. But my point is that we, as a society, turn to drugs more often – and sooner – than we should without exploring the alternatives. Much of this is not our fault; we’ve been well trained and conditioned from a young age by TV and products advertisements, our physicians, as well as our friends and family. But we are the ones who will suffer if we don’t start taking responsibility for our health, starting today.
For more information on tardive dyskinesia, please visit the website of the Tardive Dyskinesia Center.
Medications that cause Tardive Dyskinesia
While tardive dyskinesia has been associated primarily with neuroleptic drugs, other medications can cause this condition, including some medications given for digestive troubles and nasal allergies. The longer a person is on a tardive dyskinesia inducing-drug the more likely he or she is to develop tardive dyskinesia. People over age sixty-five are more likely to develop drug-induced tardive dyskinesia than younger people are. As we age, our body’s metabolism and ability to process medication changes and slows; by age sixty these changes may already be apparent.
In February 2009, the connection between tardive dyskinesia and certain medications made the news, when the FDA announced that metoclopramide would be required to carry a “black box” label warning of the risk of tardive dyskinesia with long term use. Metoclopramide is an antiemetic prescribed for gastroparesis, severe acid reflux, and other problems; it is sold under the brand names: Reglan, Octamide, and Maxolon. Patients under sixty who use this drug for three months or more run the risk of developing tardive dyskinesia; people age sixty and older are especially vulnerable and may develop tardive dyskinesia after only a month on metoclopramide.
The following overview of drugs which can cause tardive dyskinesia is by no means exhaustive. Other medications not included here can also cause tardive dyskinesia.
Neuroleptics
Neuroleptics (anti-psychotics) are medicines given for psychiatry disorders; they have proven exceptionally effective for schizophrenia. Unfortunately these wonder drugs come with a price; they can cause tardive dyskinesia. The following classes of medicines are neuroleptics which are known to cause a tardive dyskinesia diagnosis:
Butyrophenones
• Dibenzodiazepines
• Droperidol (brand name: Isapsine)
• Haloperidol (brand name: Haldol)
• Loxapine (brand names: Daxolin, Loxitane)
Diphenylbutylpiperdines
• Primozide (brand name: Orap)
Indolones
• Molindone (brand name: Moban)
Phenothiazines
• Chlorpromazine (brand name: Thorazine)
• Fluphenazine (brand names: Permitil, Prolixin)
• Mesoridazine (brand name: Serenitil)
• Perphenazine (brand name: Trilafon)
• Thioridazine (brand name: Mellaril)
• Trifluoperazine (brand name: Stelazine)
Thioxanthenes
• Thioxanthene ((brand name: Navane)
The following drugs are called atypical neuroleptics. They are newer than the traditional neuroleptics and they are less likely to cause tardive dyskinesia; however, the atypical neuroleptics are not entirely risk- free. In some cases, people taking atypical neuroleptics have developed tardive dyskinesia.
• Amisulpride (brand name: Solian)
• Olanzapine (brand name: Zyprexa)
• Quetiapine (brand name: Seroquial)
• Resperidone (brand name: Risperdal)
Anti-cholinergics
Anti-cholinergics (anti-spasmodics) are class of medications prescribed for respiratory problems such as COPD, bladder control problems, Parkinson’s disease, and other reasons. The following anti-cholinergics have commonly been given to help control some symptoms of Parkinson’s, but these drugs can cause tardive dyskinesia:
• Benzhexol
• Biperiden (brand name: Akineton)
• Ethopropazine
• Orphenadrine (brand names: Norflex, Norgesic, Orphengesic)
• Procylindine
Antidepressants
People on the following antidepressants also run the risk of developing tardive dyskinesia, although the risk is lower than with the neuroleptics:
Monoamine oxidase inhibitors (MAOIs)
• Phenelzine (brand name: Nardil)
Selective serotonin reuptake inhibitors (SSRIs)
• Fluoxetine (brand name: Prozac)
• Sertraline (brand name: Zoloft)
Trazodone
(brand name: Desyrel)
Tricyclic antidepressants
• Amitriptyline (brand name: Elavil, Vanatrip)
• Amitriptyline combined with perphenazine (brand name: Triavil)
• Amoxapine (brand name: Asendin)
• Doxepin (brand name: Sinequan)
• Imipramine (brand name: Tofranil)
Antiemetics
The antiemetics are given to quell severe nausea and acid reflux. Metoclopramide is used primarily for gastroparesis—a condition in which the stomach does not contract properly, but this powerful drug is also used for severe cases of acid reflux and to prevent aspiration pneumonia. In addition, metoclopramide may given for headaches which are due to a disorder of the cranial blood vessels. The following drugs are antiemetics that can cause tardive dyskinesia:
• Metoclopramide (brand names: Reglan, Maxolon, Octamide)
• Prochlorperazine (brand name: Compazine)
According to the Federal Food and Drug Administration, over 2 million people now take metoclopramide (Reglan, Maxolon, Octamide); the wide-spread use of this medication means that more people are now at risk for drug-induced tardive dyskinesia.
Anxiolytics
The anxiolytics are given for anxiety disorders. The following anxiolytic has been known to cause tardive dyskinesia:
• Alprazolam (brand name: Xanax)
Antiepileptic Medications
Some drugs give to prevent or reduce epileptic seizures can also cause tardive dyskinesia:
• Carbamazepine (brand names: Atretol, Epitol, Tegretol)
• Ethosuximide (brand name: Zarontin)
• Phenobarbital (brand names: Barbita, Luminal sodium, Solfoton)
• Phenytoin (brand name: Dilantin)
Anti-Parkinson’s Agents
Parkinson’s patients are especially prone to develop tardive dyskinesia and should use caution when taking any medications known to cause tardive dyskinesia; for example, metoclopramide (Reglan, Maxolon, Octamide) should only be prescribed for people with Parkinson’s if the benefits of taking the medication outweigh the risks of developing tardive dyskinesia. Some drugs given for Parkinson’s symptoms can cause tardive dyskinesia:
• Bromocriptine (brand name: Parlodel)
• Levodopa (brand names: Dopar, L-Dopa, Larodopa)
• Levodopa (brand names: (Atamet, Sinemet)
Other Drugs which can cause Tardive Dyskinesia
The mood stabilizer lithium sometimes given for bipolar disorder can cause tardive dyskinesia:
• Lithium (brand names: Cibalith-S, Eskalith, Lithane, Lithobid, Lithotabs, Lithonate)
Dopamine (brand name: Intropin) can cause tardive dyskinesia, but this drug is generally given to people in serious condition in the hospital to strengthen the heart’s pumping action, so the benefits are considered to outweigh the risk; in addition, this medication is less likely to be given long term than some other tardive dyskinesia-inducing medications.
Even the commonly given antihistamines and antihistamines with decongestants can sometimes cause tardive dyskinesia, but this is rare; antihistamines given in combination with sympathomimetics can also cause problems.
The anti-malarial drug Chlorquine (brand name: Aralen) can cause tardive dyskinesia.
The estrogens found in oral contraceptives and hormone replacements can also cause tardive dyskinesia, but this is rare.
Ritalin and Ritalin SR, two controversial drugs given to children for ADHD also can cause tardive dyskinesia. The generic name for these two medications is methylphenidate.
In addition the amphetamine Adderall can cause tardive dyskinesia; so can caffeine in large enough dose
Cheryl, Thank you for sharing such an exhaustive list of medications associated with tardive dyskinesia. Do you have any websites you can recommend for this condition that provide the most accurate, up-to-date information for treatment options? Thanks again for taking the time to share this important information! Julie
Thank you for this extensive list of medications that can cause tardive dyskinesia. My brother (I am his caregiver) is diagnosed with dystonia and the etiology is unknown. He has suffered with this diagnosis for 14 years and was prescribed the drug Haldol for many years and is still taking Trazodone. (Both these drugs are listed as causing TD). Although, I did not see the drug Colonopin (sp)? listed, I assume that it does not contribute to TD because he is also taking that drug to reduce his movement. Although, I know a little more about what might be the cause of his movement disorder, I am sadden to know that it is permanently. We were scheduled to see a movement specialist and discuss the possibility of brain stimulation (I do not know the medical name) but my brother cancelled the appointment.
Again, thank you for your work and helping everyday people get a better understanding that when we take medication to control one disease we stand the chance of incurring a side effect that can be even worse. I think this is what happened to my brother who feels his life is not worth living.
Grandmother curred TD by taking Milk Thistle and Probiotic Sustenex.