1 in 4 people taking certain mental health medications for more than 3 months may develop TD, with increased risk over time. Waln et al, 2013; Warikoo et al, 2013; Derrow, 2023. 

Antipsychotics (APDs)

Called neuroleptics; used against psychosis (when a person has lost touch with reality e.g. schizophrenia, having hallucinations, Tourette’s syndrome, depression) or other conditions (e.g. anxiety, autism, ). More people are diagnosed with TD using 1st-generation psychotics compared to 2nd generation ones. Women and older adults

1st-generation antipsychotics – causes TD in 15-30% of people treated long term. 1st-generation antipsychotics include:

• Thorazine (chlorpromazine) – also used to treat intractable hiccups, tetanus and acute intermittent porphyria
• Fluphenazine
• Haldol (haloperidol)
• Adasuve (loxapine)
• Perphenazine
• Orap (pimozide) – used to treat tics in Tourette’s syndrome
• Compro (prochlorperazine) – also used to treat anxiety
• Thiothixene
• Trifluoperazine – also used to treat anxiety

2nd-generation antipsychotics – cause TD in only 5.5% of people taking them long-term, such as:.

• Risperdal, Risperdal Consta (risperidone) – also used to treat autism
• Zyprexa, Zyprexa Relprevv and Zyprexa Zydis (olanzapine)
• Seroquel and Seroquel XR (quetiapine)
• Geodon (ziprasidone)
• Abilify and Aristada (aripiprazole) – also used to treat depression, autism and Tourette’s syndrome
• Invega (paliperidone)
• Latuda (lurasidone) – also used to treat depressive episodes

Antidepressants.

Prescribed for depression, anxiety, OCD ADD, also chronic and neuropathic pain. Risk of TD not as high as antipsychotic drugs, but taking antidepressants still carries a risk, especially in older adults.

SSRI’s (Selective SEROTONIN Reuptake Inhibitors) include:

• Celexa (citalopram)
• Lexapro (escitalopram)
• Luvox (fluvoxamine)
• Paxil (paroxetine)
• Prozac (fluoxetine) – high risk
• Zoloft (sertraline) – high risk

SNRI’s (Selective NOREPINEPHRINE Reuptake Inhibitors) include:

• Cymbalta (duloxetine)
• Effexor (Venlafaxine)
• Fetzima (levomilnacipran)
• Pristiq (desvenlafaxine)
• Savella (milnacipran)

Monoamine oxidase inhibitors (MAOIs) – used to treat depression and Parkinson’s disease.

There are some alternative treatments for antidepressants that are just as effective as mainstream meds.

Alternative treatments for anxiety / stress / depression

Other drugs

Antiemetics (prevent vomiting)

Anticholinergics. Prescribed for depression, insomnia, respiratory disease (e.g. COPD, asthma), incontinence / bladder control, Parkinson’s disease and CVD. TD can be a side effect of these drugs or worsen TD symptoms – may be reversible. Cornett et al, 2017

Anti-convulsants. Used to treat epilepsy. Especially:

• Carbamazepine (Tegretol)
• Lamotrigine (Lamictal)
• Pheytoin

Parkinson’s medications

Risk factors for developing TD are higher in:

Cornett et al, 2017

• Older people (probably because of higher medication)
• Females
• Africans / African Americans