Can Escitalopram (Lexapro) cause Tardive Dyskinesia?

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Last updated: April 8, 2025View editorial policy

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From the Guidelines

Lexapro (escitalopram) can potentially cause tardive dyskinesia, although the risk is relatively low compared to other medications like antipsychotics. Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements, typically affecting the face, mouth, and tongue. While the provided evidence does not directly mention Lexapro causing tardive dyskinesia, it discusses the potential for SSRIs to have various side effects, including those related to movement and neurological function 1. The mechanism of SSRIs like Lexapro affecting dopamine pathways in the brain could potentially contribute to the development of tardive dyskinesia, especially with long-term use or higher doses.

Key Considerations

  • The risk of tardive dyskinesia with SSRIs is generally considered lower than with antipsychotics, but vigilance is still necessary.
  • Symptoms of tardive dyskinesia include lip smacking, tongue protrusion, facial grimacing, and uncontrolled movements of the limbs.
  • If symptoms of tardive dyskinesia occur, it is crucial to contact a healthcare provider immediately for evaluation and potential adjustment of the treatment plan.
  • Management might involve dose adjustment, switching to a different medication, or adding specific treatments to mitigate the symptoms of tardive dyskinesia. Given the potential, albeit rare, risk of developing tardive dyskinesia with Lexapro, monitoring for early signs of this condition is essential for patients on long-term SSRI therapy. This approach aligns with the general principle of minimizing morbidity and maximizing quality of life by early detection and management of potential side effects 1.

From the Research

Tardive Dyskinesia and Lexapro

  • There is no direct evidence in the provided studies that links Lexapro to tardive dyskinesia 2, 3, 4, 5, 6.
  • Tardive dyskinesia is a serious and often permanent complication usually seen after the long-term use of antipsychotic medications, and multiple other classes of medications have been reported to cause TD or TD-like syndromes 2.
  • The studies provided focus on the association of tardive dyskinesia with antipsychotic medications and other classes of medications, but do not mention Lexapro specifically 3, 5, 6.
  • One study discusses the potential implications of levetiracetam in dyskinetic movements and neuropsychiatric symptoms, highlighting the need for close monitoring of patients taking this medication, especially the elderly with multiple comorbidities and compromised renal function 2.
  • Another study reviews the pathophysiology, etiology, and epidemiology of tardive dyskinesia, as well as the medications associated with TD, mechanisms of medication-induced TD, and treatments for medication-induced TD, but does not mention Lexapro 3.
  • Vitamin E has been proposed as a treatment to prevent or decrease tardive dyskinesia, but the evidence is limited and of low quality 4.
  • Atypical antipsychotics are felt to have a lower risk of TD, but cases of patients taking atypical antipsychotics who developed TD have been reported, highlighting the need for continued diligence in monitoring for the onset of TD in patients taking these medications 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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