Impact of tardive dyskinesia

Not an actual patient
TD is clinically distinct

Tardive dyskinesia (TD) is a clinically distinct, drug-induced movement disorder1,2

TD is associated with prolonged exposure to dopamine receptor blocking agents (DRBAs), including first- and second-generation antipsychotics1

TD may affect more than one area of the body—not just the face1-3

Select a body area to see examples.


  • LIPS1-3

  • TONGUE1-3

  • JAW1-3

  • TORSO1-3

  • UPPER
    LIMBS1-3

  • LOWER
    LIMBS1-3

Tardive dyskinesia (TD) facial symptoms patient Tardive dyskinesia (TD) lips symptoms patient Tardive dyskinesia (TD) tongue symptoms patient Tardive dyskinesia (TD) jaw symptoms patient Tardive dyskinesia (TD) torso symptoms patient Tardive dyskinesia (TD) upper limbs symptoms patient Tardive dyskinesia (TD) lower limbs symptoms patient
See all movements

How is TD different from other drug-induced movement disorders?

Dr. Laxman Bahroo, from Georgetown University’s Neurology Department, shows the clinical distinctions between TD and other drug-induced movement disorders.

Portrayal of tardive dyskinesia Not an actual patient
Not an actual patient

EYES/FACE1-3

Excessive blinking, squinting

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Tardive dyskinesia (TD) is a clinically distinct, drug-induced movement disorder1,2

  • EYES/FACE1-3

    Tardive dyskinesia (TD) facial symptoms patient

    Excessive blinking, squinting

  • LIPS1-3

    Tardive dyskinesia (TD) lips symptoms patient

    Smacking, puckering, pursing

  • TONGUE1-3

    Tardive dyskinesia (TD) tongue symptoms patient

    Bonbon sign, protrusion, darting

  • JAW1-3

    Tardive dyskinesia (TD) jaw symptoms patient

    Biting, clenching, lateral movements, chewing

  • TORSO1-3

    Tardive dyskinesia (TD) torso symptoms patient

    Hyperextension, shifting, rocking

  • UPPER LIMBS1-3

    Tardive dyskinesia (TD) upper limbs symptoms patient

    Asymmetrical movements, swaying, piano fingers, grabbing of clothing

  • LOWER LIMBS1-3

    Tardive dyskinesia (TD) lower limbs symptoms patient

    Splayed or hyperextended toes, gripping, ankle twisting

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How is TD different from other drug-induced movement disorders?

Dr. Laxman Bahroo, from Georgetown University’s Neurology Department, shows the clinical distinctions between TD and other drug-induced movement disorders.

TD may be disruptive

Tardive dyskinesia may be disruptive2,4

TD is a potentially irreversible drug-induced movement disorder that is often persistent1,5

Medications associated with TD include6–8

  • Psychiatric DRBAs
    • First-generation (typical) antipsychotics

    • Second-generation (atypical) antipsychotics

  • Nonpsychiatric DRBAs
    • Medications for gastrointestinal motility or nausea/vomiting

There is insufficient evidence demonstrating the benefit of stopping or switching antipsychotic agents for treating TD in some patients.9

Even after DRBA use has stopped, TD may persist9,10

TD may negatively impact patients11

TD may result in2,4

  • Embarrassment

  • Social isolation

  • Exacerbation of stigma associated with existing mental illness

See impact data

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Tardive dyskinesia (TD)a can have a meaningful negative impact and requires routine monitoring, even in mild cases1,b,c

In a recent survey, patients with mild and moderate TDa reported that TD had a meaningful impact on their lives.1,b,c


0 50 100
21%
11%
30%
34%
36%
17%
Symptomatic but not diagnosed patients (n=44)

0 50 100
8%
12%
31%
35%
19%
16%
Mild TDc (n=26)

0 50 100
41%
38%
62%
65%
56%
26%
Moderate TDc (n=68)

0 50 100
55%
61%
82%
79%
70%
63%
Severe TDc (n=33)
  • Overall Welfare
  • Physical Impact
  • Emotional Impact
  • Social Impact
  • Psychological Impact
  • Work/School Impact
  • aSelf-reported as diagnosed by a physician.
  • cPatients self-identified as having mild, moderate, or severe TD.
  • bQuestion from research: Tardive dyskinesia may impact you in many different ways. To what extent has tardive dyskinesia impacted you in each of the following areas?
    Responses were based on a 7-point Likert scale of "Not at all impacted" to "Extremely impacted." Results shown include responses of ≥6.
  • dQuestion from research: How would you rate your current ability to undertake your regular daily activities? Responses were based on a 3-point scale selection of "Low", "Medium," or "High."

Patient survey design1

The blinded online survey was conducted between April 26 and November 20, 2017. There were 2 versions of the survey:

  • Sample A, for antipsychotic patients (n=2419)
  • Sample B, for TD-diagnosed patients (n=127) and symptomatic, undiagnosed patients (n=44)

Screening criteria1

Sample A (n=2419)

  • 18 years or older
  • Diagnosed with psychiatric or gastrointestinal disorder requiring treatment with a dopamine receptor blocking agent (DRBA)
  • Have taken a DRBA within the past 2 years
  • Not diagnosed with TD

Sample B (n=171)

  • Currently taking a DRBA or have taken a DRBA in the past 12 months
  • Self-reported as diagnosed with TD by a physician (with the exception of the symptomatic, undiagnosed patients)
  • Experienced TD symptoms (involuntary, repetitive movements) after initiation of DRBA therapy

REFERENCE: 1. Data on file. Neurocrine Biosciences, Inc.

TD remains common

Routine screening may help identify patients with tardive dyskinesia

Any prolonged exposure to an antipsychotic—whether first or second generation—is a definitive risk factor for TD12

A 2017 meta-analysis of 41 studiesa found TD in patients receiving first-generation and/or second-generation antipsychotics12

30% of patients on first-generation antipsychotics had TD12

20.7% of patients on second-generation antipsychotics (with unspecified first-generation antipsychotic use) had TD12

7.2% of patients on second-generation antipsychotics with no prior history of first-generation antipsychotic use had TD12



  • aA meta-analysis was conducted using 41 full-text studies that reported on TD prevalence by drug class. Articles were published from 2000 to 2015 (to exclude earlier studies during the era of high-dose first-generation antipsychotic use). To meet the inclusion criteria, the studies were required to provide cross-sectional data from ≥15 patients treated with first-generation and/or second-generation antipsychotics to avoid the inclusion of case series, and to use a standardized rating scale to evaluate TD. The majority of studies (87.8%) used the Abnormal Involuntary Movement Scale (AIMS). Other scales included the Extrapyramidal Symptom Rating Scale, the Involuntary Movement Scale, and the dyskinesia subscale of the Matson Evaluation of Drug Side Effects.

With antipsychotic use increasing, more patients may be at risk for TD13

Increase in antipsychotic use Increase in antipsychotic use

Additional risk factors include1,14-18

  • Aged 50 or older
  • Substance abuse
  • Being postmenopausal
  • Diagnosis of mood disorder
  • History of acute extrapyramidal symptoms
  • Potency of dopamine receptor blocking agents (DRBAs)