Involuntary muscle tics may be a consequence of long-term
“antipsychotic” medication use. According to research or other evidence, the
following self-care steps may help ease TD symptoms:
- Get some extra E
- Reduce the severity of TD by taking 1,600 IU of vitamin E every
day under the supervision of a healthcare practitioner
- Discover lecithin
- Improve symptoms by taking 25 grams of this nutritional supplement
twice a day, providing 35 grams of phosphatidyl choline per day
- Mix in manganese
- Prevent onset by taking 15 mg of manganese a day, or help reverse
the condition by taking up to 60 mg per day under a healthcare provider's supervision
- Manage movement with melatonin
- With the supervision of a knowledgeable healthcare practitioner,
take 10 mg of this natural hormone each night to help reduce abnormal movements
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full tardive dyskinesia article
for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About tardive dyskinesia
Tardive Dyskinesia (TD) is a condition of abnormal, repetitive, uncontrollable movements
that develop after a long-term use of so-called antipsychotic medications used to treat schizophrenia and related psychiatric disorders.
The term “tardive” (which means “late”) is used because the condition
appears only after long-term use of these drugs, which include chlorpromazine (Thorazine), thioridazine (Mellaril), and trifluoperazine
(Stelazine). Dyskinesia means “abnormal movement.”
The uncontrollable movements of TD can interfere greatly with a person’s quality of
life. TD may gradually diminish in severity after the medication is discontinued, but all too
often the problem is permanent, persisting after withdrawal from the drugs that caused the
condition. Conventional treatment for TD is unsatisfactory, so prevention is considered
crucial. It is important that people requiring antipsychotic drugs be given the lowest
effective dose and that treatment be discontinued as soon as it is feasible.
Product ratings for tardive
What are the symptoms?
Symptoms of TD include repetitive and involuntary movements (tics), most often of the
facial muscles and tongue (such as lip smacking), although any muscle in the body can be
affected (e.g., moving legs back and forth). Symptoms may be mild or severe and can interfere
with eating and walking.
Trihexyphenidyl (Artane, Trihexy) is prescribed to treat tardive dyskinesia.
Electroconvulsive therapy (electrical current applied to the brain) may be administered in
severe cases. Healthcare providers may recommend discontinuing the use of antipsychotic drugs
Vitamins that may be helpful
Vitamin E has been found in a number of
studies to reduce the severity of TD. In a double-blind trial, people with TD were randomly
assigned to receive vitamin E (800 IU per day for two weeks and 1,600 IU per day thereafter)
or a placebo. Vitamin E was significantly more effective than placebo in reducing involuntary
movements.1 An uncontrolled study of 20 people with TD reported that 1,600 IU of
vitamin E per day may be the optimal amount;2 this large amount should be
supervised by a healthcare practitioner. Other studies have also found that vitamin E
supplements reduce the severity of TD.3 4 5 Two studies
failed to show a beneficial effect of vitamin E.6 7 However, the people
in those studies had been receiving neuroleptics for at least ten years, and research has
shown that vitamin E is most effective when started within the first five years of neuroleptic
Choline and lecithin have both been used for people with TD. While
some studies have shown a beneficial effect,10 11 12 others
have reported variable improvement13 or no improvement.14 In a small,
two-week, double-blind trial, people with TD were given 25 grams of lecithin twice a day
(providing 35 grams of phosphatidyl choline per day), or a matching placebo. All participants
experienced significant improvement of symptoms.15
Dimethylaminoethanol (DMAE) is a natural
choline precursor. Although some preliminary data suggested that DMAE could decrease TD
symptoms,16 most studies show that DMAE is no more effective than placebo for
One doctor has found that administering the trace mineral manganese (15 mg per day) can prevent the development
of TD and that higher amounts (up to 60 mg per day) can reverse TD that has already
developed.18 Other researchers have reported similar improvements with
Several people have experienced an improvement in TD while taking evening primrose oil (EPO).21 In a
double-blind study, however, supplementing with EPO (12 capsules per day) resulted only in a
minor, clinically insignificant improvement.22
Preliminary research has linked TD to the inability of the body to metabolize the amino
acid phenylalanine. Supplementing with branched-chain amino acids (BCAA), including
valine, isoleucine, and leucine, could reduce excess phenylalanine in people with this
disorder. In one trial, researchers examined the effects of BCAA supplementation in people
with TD (from 150 mg per 2.2 pounds body weight, up to 209 mg per 2.2 pounds body weight)
after breakfast and one hour before lunch and dinner for two weeks.23 The BCAA
mixture included equal parts valine and isoleucine plus 33% more leucine than either of the
other two amino acids. Of nine people treated, six experienced at least a 58% reduction in
symptoms, and all nine had a least a 38% decrease.
During a ten-year period, doctors at the North Nassau Mental Health Center in New York
treated approximately 11,000 people with
schizophrenia with a megavitamin regimen that included vitamin C (up to 4 grams per day), vitamin B3—either as niacin or
niacinamide—(up to 4 grams per day), vitamin
B6 (up to 800 mg per day), and vitamin E
(up to 1,200 IU per day). During that time, not a single new case of TD was seen, even though
many of the people were taking neuroleptic drugs.24 Another psychiatrist who
routinely used niacinamide, vitamin C, and vitamin B-complex over a 28-year period rarely
saw TD develop in her patients.25 Further research is needed to determine which
nutrients or combinations of nutrients were most important for preventing TD. The amounts of
niacinamide and vitamin B6 used in this research may cause significant side effects and may
require monitoring by a doctor.
In a double-blind trial, supplementation with 10 mg of melatonin each night for six weeks reduced abnormal
movements by 23.8% in patients with TD, compared with 8.4% in the placebo group, a
statistically significant difference.26
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
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dyskinesia. Am J Psychiatry 1993;150:1405–7.
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a preliminary study over 7 months at different amounts. Int Clin Psychopharmacol
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systematic review and meta-analysis. Schizophr Res 1999;39:1–16 [review].
18. Kunin RA. Manganese in dyskinesias. Am J Psychiatry
19. Norris JP, Sams RE. More on the use of manganese in dyskinesia.
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25. Toll N. To the editor. J Orthomolec Psychiatry
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dyskinesia. A double-blind, placebo-controlled, crossover study. Arch Gen Psychiatry