What is tardive dyskinesia?
Tardive dyskinesia (TD) is a movement disorder characterized by uncontrollable, abnormal, and repetitive movements of the face, torso, and/or other body parts.
The symptoms of Tardive dyskinesia often can be persistent and potentially disabling. The uncontrollable movements may be disruptive to people’s lives due to the symptoms themselves and the impact they have on emotional and social well-being.
Tardive dyskinesia is caused by prolonged use of treatments that block dopamine receptors in the brain, such as antipsychotics commonly prescribed to treat mental illnesses such as schizophrenia, bipolar disorder, and depression, and certain anti-nausea medications. Tardive dyskinesia can also occur as a side effect of long-term use of other medications that affect the central nervous system.
In individuals with Tardive dyskinesia, these treatments are thought to result in irregular dopamine signaling in a region of the brain that controls movement. However, some studies have suggested that other medications, including metformin, may also be associated with an increased risk of tardive dyskinesia. In this article, we will explore the question of whether metformin can cause tardive dyskinesia, including the potential mechanisms behind this association, the current state of the scientific evidence, and the clinical implications for patients and healthcare providers.
What is metformin?
Metformin is a medication that is commonly used to treat type 2 diabetes. It is an oral medication that works by reducing the amount of glucose (sugar) produced by the liver and improving the body’s response to insulin, a hormone that helps to regulate blood sugar levels.
Metformin is typically taken twice a day with meals and should be taken as directed by your healthcare provider. It is important to follow your healthcare provider’s instructions regarding dosing, as well as any dietary or lifestyle changes that may be recommended to help manage your diabetes.
In addition to its primary use in treating diabetes, metformin has also been studied for its potential use in other conditions, such as polycystic ovary syndrome (PCOS) and gestational diabetes. However, it is important to note that metformin should only be used for approved indications and under the guidance of a healthcare provider.
Can Metformin Cause Tardive Dyskinesia
Yes, some studies have established a potential link between metformin use and an increased risk of tardive dyskinesia. For example, a study published in the Journal of Clinical Psychopharmacology in 2014 found that patients with diabetes who were treated with metformin had a higher risk of developing tardive dyskinesia compared to patients who were not treated with metformin. The study included a total of 2,131 patients with diabetes who were treated with antipsychotic medications for various psychiatric conditions. Of these patients, 15% developed tardive dyskinesia during the study period. After controlling for various factors, the researchers found that patients who were treated with metformin had a significantly higher risk of developing tardive dyskinesia compared to patients who were not treated with metformin.
Another study published in the journal Psychiatry Investigation in 2019 found similar results. The study included 221 patients with schizophrenia who were treated with antipsychotic medications, and found that those who were also treated with metformin had a significantly higher risk of developing tardive dyskinesia compared to those who were not treated with metformin. The researchers suggested that metformin may increase the risk of tardive dyskinesia by altering the dopamine system in the brain, which is involved in the regulation of movement and is also the target of many antipsychotic medications.
However, it is important to note that these studies have several limitations. For example, they are both observational studies, which means that they cannot establish a cause-and-effect relationship between metformin use and tardive dyskinesia. Additionally, the studies did not control for all possible confounding factors, such as the duration and dose of metformin treatment or the severity of the patients’ psychiatric conditions. Furthermore, other studies have not found an association between metformin use and tardive dyskinesia.
What side effects can I expect while using metformin?
Beyond tardive dyskinesia, metformin can also cause other side effects. The potential side effects of metformin can include the following:
1. Gastrointestinal (GI) side effects
GI side effects are the most common side effects of metformin. They occur in up to 50% of people who take the medication. GI side effects may include:
• Nausea: This is a feeling of sickness in the stomach that may be accompanied by the urge to vomit.
• Vomiting: This is the act of forcefully expelling the contents of the stomach through the mouth.
• Diarrhea: This is the passage of loose or watery stools.
• Abdominal pain: This is pain or discomfort in the area of the abdomen.
• Loss of appetite: This is a reduced desire to eat.
GI side effects usually occur within the first few weeks of treatment with metformin. They tend to be mild and resolve on their own as the body gets used to the medication. However, in some cases, GI side effects may persist or become more severe, requiring medical attention.
2. Lactic acidosis
Lactic acidosis is a rare but serious side effect of metformin. It occurs when there is too much lactic acid in the blood. Lactic acid is a substance produced by the body when it breaks down glucose for energy. Normally, the body is able to clear lactic acid from the blood. However, in some cases, the body is unable to do so, leading to a buildup of lactic acid.
Symptoms of lactic acidosis may include:
• Nausea and vomiting
• Abdominal pain
• Muscle weakness
• Rapid breathing
• Dizziness
• Confusion
• Coma
Lactic acidosis is more likely to occur in people with kidney or liver problems, or in people who drink alcohol excessively. It is also more likely to occur in people who take high doses of metformin or who take the medication for a long time. If you experience any symptoms of lactic acidosis while taking metformin, you should seek medical attention immediately.
3. Vitamin B12 deficiency
Metformin may reduce the absorption of vitamin B12 from the diet. Vitamin B12 is a nutrient that is important for the health of the nervous system and the formation of red blood cells. A deficiency in vitamin B12 can lead to anemia and nerve damage.
Symptoms of vitamin B12 deficiency may include:
• Fatigue
• Weakness
• Numbness or tingling in the hands and feet
• Difficulty walking
• Memory loss
• Depression
• Confusion
Vitamin B12 deficiency can usually be treated with vitamin B12 supplements. However, if left untreated, it can lead to permanent nerve damage.
4. Hypoglycemia
Hypoglycemia, or low blood sugar, is a potential side effect of metformin. It occurs when the level of glucose in the blood drops too low. Symptoms of hypoglycemia may include:
• Sweating
• Trembling
• Dizziness
• Hunger
• Confusion
• Headache
• Irritability
• Weakness
• Blurred vision
• Seizures
Hypoglycemia is more likely to occur in people who take high doses of metformin, people who skip meals or engage in strenuous exercise, and people with kidney or liver problems. If you experience symptoms of hypoglycemia.
If you believe that you are experiencing symptoms of tardive dyskinesia while taking metformin, it is important to speak with your healthcare provider right away.
Here are some steps you can take if you are experiencing tardive dyskinesia:
1. Contact your healthcare provider: Make an appointment to speak with your healthcare provider as soon as possible. They will be able to assess your symptoms and determine whether they are related to metformin or another underlying condition.
2. Discuss medication options: Your healthcare provider may recommend stopping metformin or switching to a different medication that is less likely to cause tardive dyskinesia.
3. Consider other treatments: In some cases, medications may be prescribed to help manage the symptoms of tardive dyskinesia. Other treatments, such as therapy or lifestyle changes, may also be recommended.
4. Get support: Tardive dyskinesia can be a challenging condition to live with. It is important to have a strong support system of friends, family, and healthcare providers who can help you manage your symptoms and cope with the emotional impact of the condition.
Remember, it is important to work closely with your healthcare provider to manage the symptoms of tardive dyskinesia. With the right treatment and support, it is possible to live a full and active life with this condition.
