1. Metoclopramide (Reglan)

Often prescribed for gastrointestinal issues such as acid reflux and delayed stomach emptying (gastroparesis), metoclopramide works by increasing gut motility. However, long-term use has been linked to an increased risk of developing TD, especially in older adults. The FDA even issued a black box warning about this risk, making it one of the most dangerous non-psychiatric drugs for TD.

2. Prochlorperazine (Compazine)

Commonly used to treat severe nausea and vomiting, prochlorperazine belongs to the class of dopamine antagonists, similar to antipsychotic medications. While effective for short-term use, long-term exposure has been associated with a higher risk of TD, particularly in older adults and those with a history of neurological conditions.

3. Fluoxetine (Prozac)

As one of the most commonly prescribed selective serotonin reuptake inhibitors (SSRIs) for depression and anxiety, fluoxetine may not seem like a high-risk medication for TD. However, some studies suggest that SSRIs can trigger or worsen movement disorders in people predisposed to TD, particularly when taken in high doses or for extended periods.

4. Promethazine (Phenergan)

This medication is widely used as an antihistamine, anti-nausea, and sedative drug. Like prochlorperazine, promethazine affects dopamine receptors, which can lead to movement-related side effects, including extrapyramidal symptoms and tardive dyskinesia. Long-term or high-dose use increases the risk, making it a concern for individuals prone to TD.

5. Citalopram (Celexa)

Another SSRI, citalopram is prescribed for depression and anxiety disorders. While its primary function is to regulate serotonin levels, there is evidence that long-term use may influence dopamine pathways, potentially triggering TD symptoms. Older adults and those taking multiple psychiatric medications are at an even higher risk.

6. Haloperidol (Haldol)

A high-potency antipsychotic used to treat schizophrenia and severe agitation, haloperidol is one of the most well-documented causes of TD. Even short-term use can increase the likelihood of developing irreversible movement disorders, making it one of the riskiest medications for those predisposed to TD.

What Should You Do If You’re Taking These Medications?

If you’re currently taking any of these medications and are concerned about TD, do not stop taking them abruptly. Instead:
✔️ Speak with your doctor about alternative treatments.
✔️ Ask about TD-specific medications that may help manage symptoms.
✔️ Consider lifestyle adjustments, such as stress reduction and physical therapy.

Tardive Dyskinesia can be debilitating, but being informed about which medications to avoid is an essential step in managing the condition. If you suspect you’re experiencing symptoms, consult with a healthcare professional as soon as possible to explore safer alternatives.