50 Drugs That Cause Tardive Dyskinesia

50 Drugs That Can Cause Tardive Dyskinesia: A Comprehensive Guide

Tardive dyskinesia (TD) is a serious, potentially irreversible movement disorder that can develop as a side effect of taking certain medications, primarily antipsychotics. Understanding which medications carry this risk is crucial for both healthcare professionals and patients. This article provides a comprehensive list of 50 drugs that have been associated with TD, along with important information about risk factors and management. It's crucial to remember that this list is not exhaustive, and the risk of developing TD varies depending on factors like dosage, duration of treatment, individual susceptibility, and other health conditions. Always consult with your doctor or psychiatrist before starting or stopping any medication.

Introduction to Tardive Dyskinesia

Tardive dyskinesia is characterized by involuntary, repetitive movements, most commonly affecting the face, mouth, tongue, and limbs. These movements can range from subtle twitches to severe, disabling spasms. The symptoms can be distressing and significantly impact a person's quality of life, affecting their ability to eat, speak, and perform daily activities. While TD can sometimes improve after the medication is stopped, it often persists, even becoming permanent in some cases. The exact mechanism by which these drugs cause TD is still not fully understood, but it's believed to involve changes in dopamine receptors in the brain.

Risk Factors for Developing Tardive Dyskinesia

Several factors increase the risk of developing TD:

• Age: Older adults are at a higher risk.
• Sex: Women may be slightly more susceptible.
• Duration of treatment: Longer exposure to the medication increases the risk.
• Dosage: Higher doses increase the risk.
• Pre-existing neurological conditions: Individuals with a history of neurological disorders may be more vulnerable.
• Other medical conditions: Certain medical conditions can increase susceptibility.
• Genetic predisposition: Family history of TD may slightly increase the risk.

List of 50 Drugs Associated with Tardive Dyskinesia

This list is categorized for clarity and includes both brand names and generic names where applicable. This list is not exhaustive and should not be considered medical advice. Always consult with a healthcare professional for any concerns about medication side effects.

1. Antipsychotics (Neuroleptics): This is the largest category of drugs associated with TD.

• First-generation antipsychotics (FGAs) – High risk:
  1. Haloperidol (Haldol)
  2. Fluphenazine (Prolixin)
  3. Thiothixene (Navane)
  4. Perphenazine (Trilafon)
  5. Trifluoperazine (Stelazine)
  6. Chlorpromazine (Thorazine)
  7. Thioridazine (Mellaril)
  8. Loxapine (Loxitane)
  9. Molindone (Moban)
• Second-generation antipsychotics (SGAs) – Lower risk, but still possible: 10. Risperidone (Risperdal) 11. Olanzapine (Zyprexa) 12. Quetiapine (Seroquel) 13. Ziprasidone (Geodon) 14. Paliperidone (Invega) 15. Aripiprazole (Abilify) 16. Clozapine (Clozaril) 17. Asenapine (Saphris) 18. Iloperidone (Fanapt) 19. Lurasidone (Latuda)

2. Antiemetics (Anti-nausea Medications):

20. Metoclopramide (Reglan)
21. Prochlorperazine (Compazine)
22. Promethazine (Phenergan)

3. Antidepressants:

23. Amitriptyline (Elavil)
24. Nortriptyline (Pamelor)
25. Imipramine (Tofranil)
26. Desipramine (Norpramin)
27. Clomipramine (Anafranil)

4. Other Medications:

28. Metoclopramide (Reglan) -  Also listed as an antiemetic, due to its high risk.
29. Prochlorperazine (Compazine) -  Also listed as an antiemetic, due to its high risk.
30. Domperidone (Motilium) - Note:  availability varies by country.
31. Droperidol (Inapsine)
32. Procyclidine (Kemadrin)
33. Benztropine (Cogentin)
34. Biperiden (Akineton)
35. Trihexyphenidyl (Artane)
36. Diphenhydramine (Benadryl) -  Usually at higher doses.
37. Chlorprothixene (Truxal)
38. Sulpiride (Eglonyl)
39. Amisulpride (Solian)
40. Sultopride (Depixol)
41. Ziprasidone (Geodon) -  Also listed as an SGA.
42. Lithium (Lithobid) – Though less common, association exists.
43. Valproic acid (Depakene) – Though less common, association exists.
44. Carbamazepine (Tegretol) – Though less common, association exists.
45. Lamotrigine (Lamictal) – Though less common, association exists.

5. Medications Used in Parkinson's Disease Treatment (Often Used to Treat Drug-Induced Parkinsonism): This category warrants special mention because these are sometimes used to counteract the extrapyramidal side effects of other medications, yet they can still contribute to TD risk in certain situations.

46. Amantadine (Symmetrel)
47. Selegiline (Eldepryl)
48. Pramipexole (Mirapex)
49. Ropinirole (Requip)
50. Levodopa (Dopamine precursor) – although rarely causes it directly, the interplay with dopamine systems can be a contributing factor.

Scientific Explanation of Tardive Dyskinesia Mechanism

TD is thought to be caused by long-term changes in the brain's dopamine system. Dopamine is a neurotransmitter crucial for movement control. Many antipsychotic medications work by blocking dopamine receptors. While this is effective in reducing psychotic symptoms, prolonged blockage can lead to compensatory changes in the brain, including increased sensitivity of dopamine receptors. When the medication is stopped, this hypersensitivity can result in the uncontrolled movements characteristic of TD. The exact mechanisms involved are complex and are still being researched. It's also important to note that while dopamine dysregulation is central, other neurotransmitter systems, like glutamate and serotonin, might also play a role.

Frequently Asked Questions (FAQs)

• Q: Can TD be reversed? A: Unfortunately, TD is often irreversible, but some individuals experience improvement after medication is discontinued. Early detection and intervention are vital.

• Q: How is TD diagnosed? A: Diagnosis is usually based on a clinical evaluation, observing the characteristic involuntary movements. There's no single definitive test for TD.

• Q: What are the treatment options for TD? A: Treatment options focus on managing symptoms and may involve medication adjustments or the use of other medications like valbenazine or deutetrabenazine. In some cases, supportive therapies like physical therapy might be beneficial.

• Q: How can I reduce my risk of developing TD? A: Regular monitoring by your healthcare provider is crucial. Using the lowest effective dose of medication for the shortest necessary duration is vital. Open communication with your doctor regarding any concerns or side effects is also important.

• Q: Is there a screening tool for TD? A: Yes, several rating scales, like the Abnormal Involuntary Movement Scale (AIMS), are used to assess for the presence and severity of TD. These scales aid healthcare professionals in monitoring for TD and making informed decisions.

Conclusion

Tardive dyskinesia is a serious potential side effect of many medications, particularly antipsychotics. While the risk can be mitigated through careful medication management and monitoring, there's no guarantee of preventing it. This list provides a comprehensive overview of medications associated with TD, emphasizing the importance of open communication with your healthcare provider, regular monitoring, and the use of the lowest effective dose for the shortest duration. Always prioritize a collaborative approach with your physician in managing your medication and addressing any concerns about potential side effects. Early detection and intervention can significantly improve the outcome and quality of life for individuals experiencing TD. Remember, this information is for educational purposes and does not constitute medical advice. Consult a healthcare professional for personalized guidance regarding your medication and any concerns about TD.