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Tardive Dyskinesia

5 Tardive Dyskinesia Treatments That Can Ease Symptoms

Tracy Norfleet, MD, FACPPatricia Pinto-Garcia, MD, MPH
Written by Tracy Norfleet, MD, FACP | Reviewed by Patricia Pinto-Garcia, MD, MPH
Published on June 6, 2023

Key takeaways:

  • Tardive dyskinesia is a movement disorder that causes the involuntary movement of the face, upper body, arms, and legs.

  • There’s no cure for tardive dyskinesia. But VMAT2 inhibitors, like valbenazine (Ingrezza) and deutetrabenazine (Austedo, Austedo XR), can ease and sometimes stop movements. 

  • Ginkgo biloba is a natural remedy that can help symptoms, too. People often take it along with prescription medications.

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Tardive dyskinesia is a condition that causes involuntary (uncontrolled) movements of the face, upper body, hands, arms, and legs.

Most people develop tardive dyskinesia after taking a medication that blocks a chemical called dopamine. You’re at higher risk for developing tardive dyskinesia after taking these medications at high dosages and for a long time. But it can also occur when people, especially older adults, take these medications for a short time.

Tardive dyskinesia can get in the way of daily life. But there are ways to lessen these movements, including prescription and natural treatments.

How do you treat tardive dyskinesia?

There’s no cure for tardive dyskinesia. But the condition isn’t always permanent

And there are medications that can help ease or lessen involuntary movements. Medications can even reverse tardive dyskinesia in some people. This reversal can last weeks to years. Let’s take a look at five medications that can ease symptoms.

1. Valbenazine

Valbenazine (Ingrezza) is one of two FDA-approved treatments for tardive dyskinesia. It’s a VMAT2 inhibitor. VMAT2 inhibitors are a newer class of medications that work by lowering the amount of dopamine and other related chemicals stored in the brain. 

Valbenazine is taken once a day. Most people start with a 40 mg dose and then gradually raise it to 80 mg.

In a clinical study, tardive dyskinesia symptoms significantly lessened among people taking valbenazine, even if they were still taking dopamine-blocking medications. Symptoms lessened even with lower doses. Most people experienced few, if any, side effects from the medication. 

2. Deutetrabenazine

Deutetrabenazine (Austedo, Austedo XR) is another VMAT2 inhibitor that is FDA approved to treat tardive dyskinesia. 

Deutetrabenazine is usually taken twice a day. Most people start with 6 mg twice a day and then gradually raise it to 36 mg to 48 mg per day. A newer, once daily extended form is now available. 

In clinical studies, most people had fewer abnormal movements after taking deutetrabenazine. Another study showed similar results with doses as low as 24 mg per day.

Right now, there’s no data showing whether one VMAT2 inhibitor works better than another. Experts recommend offering VMAT2 inhibitor treatment to all people with tardive dyskinesia. There are ongoing studies looking at how these medications help people over longer periods of time. 

3. Tetrabenazine

Tetrabenazine (Xenazine) is an older VMAT2 inhibitor that is FDA approved to treat Huntington’s disease. It is sometimes used off-label to treat tardive dyskinesia. In smaller studies from the 1970s and 1980s, people who took tetrabenazine saw improvement in their movements. 

4. Clonazepam

Clonazepam (Klonopin) is a benzodiazepine that’s sometimes recommended off-label for tardive dyskinesia. Before VMAT2 inhibitors were available, it was one of the few treatment options for people with tardive dyskinesia. Some experts still use it as an add-on treatment in situations where people have mild tardive dyskinesia symptoms and anxiety. 

It’s not clear how well clonazepam works to treat tardive dyskinesia. Small studies suggest that clonazepam did not work better than a placebo (sugar pill) to ease tardive dyskinesia symptoms. Clonazepam is addictive, and it isn’t meant for long-term use. 

5. Deep brain stimulation

Deep brain stimulation is a medical procedure where a surgeon places a device inside the brain. This device sends electrical signals to parts of the brain that control movement.

There’s not much research on deep brain stimulation and tardive dyskinesia. But it’s a treatment option for people who don’t get better with medication. 

Can you treat tardive dyskinesia naturally?

Natural treatments won’t cure tardive dyskinesia. But, when added to medication, some natural approaches can help ease movements.

Ginkgo biloba

Ginkgo biloba is a supplement that has been a part of traditional Chinese medicine for centuries. There’s some evidence that ginkgo biloba can help lessen tardive dyskinesia movements. These studies were small and only included people who developed tardive dyskinesia during treatment for schizophrenia. But experts say it can be a safe and helpful add-on treatment

Self-care

Self-care strategies may help too. There’s not a lot of research on this area. But focusing on self-care has very little risk and may bring a range of health benefits. Here are some things to focus on:

The bottom line

Tardive dyskinesia is movement disorder that causes involuntary movements of the body, typically in the face. Dopamine-blocking medications can trigger tardive dyskinesia, especially when used at high dosages and for long periods of time. There’s no cure for tardive dyskinesia, and there’s no way to reverse it either. 

But there are treatments that can ease symptoms or even stop them all together. Options include prescription medications, like VMAT2 inhibitors and benzodiazepines. When used along with prescription options, natural remedies like ginkgo biloba and self-care can also help ease symptoms. 

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Why trust our experts?

Dr. Tracy Norfleet is a board-certified Internal Medicine physician, health expert, and physician leader with over 20 years of experience practicing adult medicine. Dual-certified by the American Board of Obesity Medicine and the American Board of Lifestyle Medicine, Dr. Tracy possesses a wealth of knowledge and expertise in both traditional medical practices and innovative lifestyle interventions for chronic disease management and reversal.
Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

References

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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