Reviewed by Veena Angle, MBBS, MD and Physician Chu I Ta

Tardive Dyskinesia: When Prescription Medication Does More Bad Than Good

Published January 14, 2023| 8 min read

Tardive dyskinesia is a rare side effect of certain medications that develop following continued use. Here is how traditional remedies can help.

Senior man wearing glasses reading information written on a medicine bottle.

What happens when taking medication does more harm than good? Tardive dyskinesia is a side effect of certain medications which cause involuntary facial movements. Thankfully, this side effect is uncommon and usually occurs following the use of medications to treat mental illness. At times, the symptoms may disappear when the medications are changed, but not always.

The word “tardive” means late, and “dyskinesia” means involuntary movements of the body. This condition develops years after a patient has taken the medicine responsible for it. It can be seen most commonly with the use of antipsychotic medications, and approximately one in four people who take the medications develop it.

Traditional Chinese Medicine (TCM) attributes tardive dyskinesia to the deposition of the medicine in the body following long-term use. Real Health Medical’s Chief Physician Chu I Ta explains that, “The deposited medicine causes Excessive Heat Toxicity, which can lead to potential damage to the Liver, Spleen and stomach, and eventually the Kidneys.”

The toxicity can cause various clinical syndromes, such as:

Excess Heat in the stomach and deposit of Phlegm-Dampness
Deficiency of Liver Yin and malnourishment of the tendons
Spleen and Kidney Deficiency and weak vital qi (vital energy)

Though it mostly takes years for the medicine to accumulate and for symptoms to appear, at times, they may show in as few as three months of starting treatment.

Symptoms and Effects of Tardive Dyskinesia

Woman with a surprise expression checking her face in the mirror. — Symptoms of tardive dyskinesia develop after taking certain prescription medicines for a long time.

Most people with tardive dyskinesia have mild symptoms. Many aren’t even aware that they’re making involuntary facial movements. The most common symptoms are rapid blinking, chewing movements, frowning, lip smacking, sticking the tongue out and making sucking motions with the mouth.

Sometimes, other body parts such as the hands and legs may also be involved. People may make repetitive finger movements like playing the piano, walking with a duck-like gait or thrusting or rocking the pelvis.

Though most tardive dyskinesia symptoms are not severe, they often cause a person to be self-conscious and withdraw from social contact. Social isolation can cause depression and anxiety and affect one’s ability to work. Rarely, the symptoms may progress to serious issues like breathing difficulties, dental problems, facial changes, difficulty swallowing and speech problems.

The symptoms of tardive dyskinesia usually resolve or decrease in intensity when the medication that is triggering it is stopped, or when the dosage is lowered.

Treatment of Tardive Dyskinesia

Prevention is better than cure. Ideally, you should avoid medications that are known to cause tardive dyskinesia. There is no definitive treatment for the condition. If symptoms persist, a drug called tetrabenazine used for movement disorders may help.

TCM herbs and acupuncture can help with the symptoms. Physician Chu advises patients to consult with a licensed TCM practitioner who can identify the syndrome and prescribe medicines according to each patient’s unique body constitution.

Herbal remedies

Physician Chu emphasises that he usually identifies the pathological syndrome before prescribing herbal remedies to his patients.

Excess stomach Heat and deposition of Damp phlegm

“Patients have involuntary movements of the lips and tongue, like chewing, grimacing or frowning, smacking the lips, neck deviation, and mumbling with poor speech,” he notes. “They may also suffer from irritation and restlessness. The tongue is generally deep red in colour with thin yellowish coating.”

Physician Chu treats them with herbs such as gypsum (shi gao, 石膏), Chinese foxglove root (sheng di huang, 生地黄), Dwarf Liliturf (mai dong, 麦冬), and Mongolian akegourd root (tian hua fen, 天花粉), which help clear stomach Heat and resolve Damp phlegm.

Deficiency of Liver Yin and malnourishment of tendons

Patients experience involuntary movements of limbs, repetitive finger movements like grasping a ball or playing the piano, stepping legs, and even walking with a duck like-gait. They may also have tongue thrusting, grinding teeth, dizziness, ringing in the ear, dry eyes, or blurry vision. The tongue is usually red with less coating.

Physician Chu seeks to improve Liver yin and nourish tendons in such patients with herbs such as Chinese foxglove root, Radix rehmanniae preparate (shu di huang, 熟地黄), Ructus ligustri lucidli (nu zhen zi, 女贞子), white peony root (bai shao, 白芍), and Angelica root (dang gui, 当归).

Spleen and Kidney Deficiency and weak vital qi

Symptoms that show include involuntary movements of smacking lips and sucking motion with the mouth, difficulty swallowing, and occasional movement of the extremities. They may also suffer from lethargy, pale complexion, chest palpitations, and a slim figure with poor appetite. The tongue is usually pale tongue with a thin coating.

In such patients, Physician Chu aims to strengthen the Spleen and kidneys, and improve vital qi with herbs like Codonopsis pilosula (dang shen, 党参), dried Atractylodes (bai zhu, 白术), poria (fu ling, 茯苓), Chinese foxglove (shu di huang, 生地黄), wolfberry (gou qi zi, 枸杞子), hawthorn (shan za, 山楂), and malt (mai ya, 麦芽).

Acupuncture

Acupuncture is very effective in treating the symptoms of tardive dyskinesia, says Physician Chu. He suggests the following acupoints:

Head: Bai hui (GV20, 百会), si shen cong (EX-HN1, 四神聪), shen ting (GV24, 神庭)，tou wei (ST8, 头维)，shuai gu (GB8, 率谷)

An illustration image of Baihui acupoint (DU20) — Bai hui is located at centre top of the head.

Sishencong image — Si shen cong is located on the vertex of the neck, consisting of four points.

Shen Ting — Stimulation of the shen ting acupoint can help manage the symptoms of social anxiety.

At the corner of the forehead, 0.5 finger-breadths within the hairline at the corner of the forehead, 4.5 finger-breadths lateral from the midline of the head.

In the temporal region, in the slight depression 1.5 finger-breadths directly above the apex of the ear.

Face: Xia guan (ST7, 下关), di cang (ST4, 地仓), jia che (ST6, 颊车), quan liao (SI18,颧髎)

Xia guan — At the lower border of the cheekbone, in the depression anterior to the condyloid process of the lower jawbone.

di cang — Directly below the pupil lateral to the corner of the mouth.

jia che — One finger width anterior and superior to the angle of the lower jawbone at the belly of the cheek muscle with teeth clenched.

quan liao — Directly below the outer corner of the eye in a depression on the lower border of the cheekbone.

Hand: Wai guan (SJ5, 外关), qu chi (LI11, 曲池), shou san li (LI10, 手三里), he gu (LI4, 合谷)

Wai guan — On the dorsal aspect of the forearm, on the line connecting yang chi (SJ4) and the tip of the elbow, two finger-breadths above the transverse crease of the wrist between the ulna and radius bones.

When the elbow is flexed, qu chi is in the depression at the lateral end of the transverse cubital crease, midway between chi ze (LU5) and the lateral epicondyle of the humerus.

shou san li — Located at the end of the elbow crease, two thumb-widths down along the forearm muscle.

An illustration of the he gu or LI4 acupoint as one of the acupressure points to relieve a runny nose — He gu is useful in helping rebalance the flow of qi and expel Wind, providing relief from allergy symptoms.

Leg: Yang ling quan (GB34, 阳陵泉), zu san li (ST36, 足三里), san yin jiao (SP6, 三阴交), tai xi (KI3, 太溪)，zu lin qi (GB41, 足临泣), tai chong (LR3, 太冲)

Yang ling quan — On the lateral side of the lower leg, in the depression anterior and inferior to the head of the fibula.

An illustration of zu san li acupressure point for teeth health in pregnant women. — Zu san li point is about 2-3 inches below your knee cap, right between the two bones of your lower leg.

An illustration of san yin jiao acupressure point to help skin pigmentation issues. — San yin jiao is about 4 finger-breadths above the ankle.

3D illustration of the tai xi acupressure point — Located on the tibial aspect of the leg, posterior to the medial border of the tibia, three finger widths inferior to the yin ling quan acupoint.

zu lin qi — On the lateral side of the dorsum of the foot, proximal to the fourth metatarsophalangeal joint, in the depression lateral to the tendon of the extensor digiti minimi muscle of the foot.

An illustration of tai chong acupressure point for teeth health in pregnant women. — Located about two finger widths below the spot where the skin of your big toe and second toe join together.

Abdomen: Zhong wan (CV12, 中脘), guan yuan (CV4 , 关元), qi hai (CV6, 气海)

Zhong wan — Located on the front of the upper abdomen, mid-point between the tip of the sternum and the navel. It dispels pathogens for improved qi and blood circulation within the upper abdominal cavity and revitalises the Spleen’s function.

guan yuan — Located along the midline of the lower abdomen, 4 fingers-breadth below the navel. It dispels pathogens for improved qi and blood circulation within the lower abdominal cavity and revitalises Kidneys’ yang energy.

Located along the midline of the lower abdomen, 2 fingers-breadth below the navel. It dispels pathogens for improved qi and blood circulation within the lower abdominal cavity and revitalises kidneys' yang energy. — Located along the midline of the lower abdomen, 2 fingers-breadth below the navel. It dispels pathogens for improved qi and blood circulation within the lower abdominal cavity and revitalises kidneys’ yang energy.

Back: Xin shu (BL15, 心俞), pi shu (BL20, 脾俞), gan shu (BL18 , 肝俞), shen shu (BL23, 肾俞), ming men (GV4, 命门).

Located 1.5 finger-breadths lateral to the lower border of the spinous process of the 5th thoracic vertebra.

pi shu — Pi shu is located 1.5 finger-breadths lateral to the lower border of the spinous process of the eleventh thoracic vertebra.

An illustration of Gan Shu (BL18) acupoint to help with alopecia areata — Gan Shu point can be found 2 fingers-breadth to the lower border of the spinous process of the 9th thoracic vertebra.

shen shu — Located on the back, 1.5 finger-breaths lateral to the lower border of the spinous process of the 2nd lumbar vertebra.

Located at the lower border of the second lumbar vertebra, roughly opposite the belly button.

Tardive dyskinesia is an example of how medication can have negative effects on the body. Thankfully, traditional medicines can be used as a remedy for conditions caused by modern medicines. Do consult a TCM practitioner to get the best treatment for your symptoms if you think you might be experiencing signs of the conditon.