Tardive dyskinesia is a major adverse to antidepressants?

It is, and it happens with many medicines used in psychiatry.


As the name 'tardive' implies, the effects are delayed, so it won't be evident for some time - perhaps years - after a long course of such medications.


Our nerves are coated in a protective myelin sheath. The medication damages the myelin sheath so that the nerves are no longer as insulated as they were. This leads to involuntary movements such as a facial tic, or writhing movements over the body. It is not painful, but it is uncontrollable and embarrassing. Sometimes the tics involve making sounds, gestures or shouting.


These side effects are not very nice, so why are these medicines used? Its a difficult decision that is not taken lightly. Sometimes their use is the only way to make life better for the patient. The hope is that the medicines can be used for a short time and then the patient hopefully improves and can be helped with less drastic medication and psychotherapy. Newer medicines are less damaging, and they are usually prescribed first, but if they don't work and the patient is very ill, then as the lesser of two evils, the heavier drug may be prescribed.


Sometimes anti Parkinsons drugs are prescribed to counter the effects of the medicine that causes tardive dyskinesia, but although they help a bit, they don't help enough for most doctors to feel that adding yet another drug to a patient is a good thing.


There are support groups for people with tardive dyskinesia.