#dyskinesia

Tardive dyskinesia (TD) is a neurological condition that involves involuntary movement of the face, neck, limbs, or trunk muscles. It is broasly defined as a tic disorder, like Tourette's. It's caused by the use of certain medications, and is most often associated with first-generation antipsychotics. In fact, according to The Mayo Clinic, at least 20% of people using first-gen antipsychotics develop TD. However, it can also be caused by other types of medications. I got mine from my antidepressant.

During my last year of high school, increasing pressure in school led me to switching from escitalopram (aka Lexapro) to bupropion (aka Wellbutrin). And to its credit, Wellbutrin worked about as well as it could or really needed to, so I stayed on it. Until around June 2022, when in a movie theater I noticed that my mouth felt tight, as if my cheeks weren't sitting right on my teeth. So I smirked a little, trying to wiggle the feeling away. As an autistic person, weird body sensations weren't anything new to me, so I didn't think anything of it. Until I couldn't stop doing it. Nothing would make the feeling in my mouth stop. I didn't say anything about it at the time, because I figured it wouldn't get taken seriously by my GP. After all, I was a young female-presenting patient during a time where people "faking Tourette's" was considered a major trend. So I hid it for months. And the tics spread, from my face to my neck and shoulders. It got to the point where I didn't even notice I was doing it as I talked, and I worried about how it would affect my ability to drive. By the time I finally switched back to Lexapro, the neuromuscular pathways were formed, and there was nothing else that can be done. Although they're a lot less frequent nowadays, I still grimace when I'm tired or stressed, and sometimes I'll even shimmy my shoulders or stretch my neck to the side.

The only reason why I even knew TD was a condition was because I watched a psychiatrist youtuber reacting to old videos about psych wards, wherein he mentioned it as a side effect of the antipsychotics they would've used at the time.

While some have reported early intervention can reverse it, TD is hard to spot in its early stages and it gets progressively worse as you continue to take the medication that caused it. If not caught in time, it is likely to be irreversible.

They need to test my parents to see if they have it too because that will determine whether or not that's what's causing my symptoms, but they've Isolated it to the DYT-ADCY5 gene!

They also found 5 other genetic changes weighing the dystonia panel, but those are all benign!

The stereotypical historical image of the psychiatric patient locked in an asylum, with a twitching face, contorted expressions and bizarre, thrashing movements of their limbs was not a result of their mental health issues, but instead was a result of the treatment they received. Phenothiazines were first used in the 1950′s to treat schizophrenia and other psychotic disorders. They were hailed as miracle drugs, finally a treatment that actually reduced the symptoms of the disorders instead of just sedating patients.

Over the course of several years professionals discovered that these miracle drugs had some horrific side effects. They would induce movement disorders similar to Parkinson’s Disease. One of the most severe manifestations of these disorders was tardive dyskinesia. This side effect was characterised by grimacing face, rapid jerking movements, protrusion of the tongue, smacking of the lips and excessive blinking. Patients may have difficulty breathing because of excessive grunting and twisting of the torso. When the lower limbs were affected walking could be impaired to the point of disability. These movements are entirely involuntary and manifested themselves late in the course of treatment. The most tragic aspect of tardive dyskinesia is the permanence of the damage, even with discontinuation of the drug the movement disorder remains.