What Is Tardive Psychosis?

Antipsychotic drugs are often a first-line treatment for people living with psychosis. While antipsychotics can bring relief from psychotic symptoms and may prevent psychotic episodes, some people may experience a relapse of psychotic symptoms, called “tardive psychosis,” after long-term use. In this article, we’ll explore what tardive psychosis is and who is at risk for developing the condition.

Get help navigating antipsychotic side effects

Connect with a licensed therapist

What is psychosis?

When you become disconnected from reality, this is usually called being in a state of psychosis. Psychosis is a condition that can cause changes in your thinking, emotions, and perceptions. It can also make it hard to tell what’s real and what’s not. 

Although psychosis often occurs in young adults, it may happen in people of all ages. It can have a variety of possible causes, such as those listed below:

• Schizophrenia
• Bipolar disorder
• Substances or alcohol
• Dementia
• Depression
• Head injuries
• Extreme stress

Psychotic episodes may not look the same for everyone. However, common symptoms of psychosis include the following:

Hallucinations

When you hallucinate, you’re generally experiencing something that isn’t real. People in psychosis may hear voices or see things that aren’t really there, like colors, shapes, or figures. Some people may also smell, taste, or feel things that aren’t there. 

Delusions

A delusion can be seen as a false belief that someone can’t be talked out of, even with logic or proof that it’s not true. For example, someone experiencing psychosis might believe that the government is spying on them, that their thoughts are being implanted in their mind, or that they have superhuman powers. 

Changes in thoughts and speech

Psychosis may make people’s thoughts hazy and disorganized. This can come across in the ways they talk. For example, someone having a psychotic episode might jump between topics, invent new words, repeat themselves, or mimic other people’s ways of speaking. 

According to the Yale School of Medicine, as many as 25% of people who have a psychotic episode will never have another one. Conditions like schizophrenia may cause people to have multiple psychotic episodes during their lives, although these can often be managed with proper treatment. 

Understanding antipsychotic medications

For people with psychosis who need ongoing treatment, neuroleptic treatment is often the first step. Neuroleptic medication, also known as “antipsychotic medication,” may reduce symptoms like hallucinations and delusions. 

In general, there are two antipsychotic medications types a doctor may prescribe:

Typical antipsychotics

Typical antipsychotics normally work by changing levels of the brain chemical dopamine, which typically plays a role in movement, motivation, and pleasure. These medications are older and tend to have more severe side effects. 

Atypical antipsychotics

Atypical antipsychotics are newer medications that may have less severe side effects. Along with dopamine, they also tend to affect levels of serotonin, a brain chemical that plays a role in mood, behavior, and memory. 

These medications may help people better manage psychotic symptoms and avoid future psychotic episodes. 

What is tardive psychosis?

While antipsychotic medications can often be beneficial, both types may have side effects. For example, people taking antipsychotics may be at a higher risk of unhealthy cholesterol levels, which is why they often need to monitor their health with frequent blood tests. 

Taking antipsychotics, especially for a long time, can lead to other complications as well. Some examples include the following:

Neuroleptic malignant syndrome

Also known as NMS, this is a serious nervous system condition that can cause symptoms like a high fever and unstable blood pressure. While neuroleptic malignant syndrome typically develops within the first few weeks of starting an antipsychotic treatment, some people may experience it later on.

Tardive dyskinesia

This is a condition that may start after taking antipsychotics for many years. Tardive dyskinesia may be more common with older antipsychotic medications, like Chlorpromazine. It can cause involuntary movements like grimacing, twitching, rapid blinking, and restlessness. 

Parkinsonism

This condition can cause symptoms similar to Parkinson’s disease, such as shaking and difficulty walking. Parkinsonism tends to be more common in older adults and women. 

Tardive psychosis: Return of symptoms

In some cases, people who have been taking antipsychotics for a long time may experience a return of their symptoms, even if their psychosis was well-managed for many years. In the 1970s, scientists used the term “tardive psychosis” to describe this phenomenon. 

In medicine, the word “tardive” can be used to describe symptoms that appear after a delay. This is why the term “tardive dyskinesia” is used to describe movement disorders that start after long-term antipsychotic use. 

Get help navigating antipsychotic side effects

Connect with a licensed therapist

Getting help for tardive psychosis

Antipsychotic medications are often helpful for people living with delusions and hallucinations. However, side effects like tardive psychosis can be challenging. If you notice symptoms that worry you, you may want to discuss them with your doctor. They may recommend alternative treatments to help you manage your symptoms. 

Managing the side effects of antipsychotics can be stressful. Some research suggests that stress may contribute to conditions like supersensitivity psychosis. Having ongoing mental health support from a therapist may make it easier to keep your stress levels in check. A counselor may help you develop healthy coping strategies, prioritize self-care, and improve your overall well-being.

That said, finding a clinical practice in your local area and a therapist with whom you connect can sometimes take multiple tries. This could be challenging if you’re already living with psychosis or other sources of stress. Online therapy platforms usually let you change therapists at any time for no additional charge. This may make the process of finding the right therapist easier. 

Studies have found that online therapy may improve stress levels. In a 2022 review, researchers looked at data from 13 studies of online therapy for elevated stress. They concluded that internet-based therapy may reduce perceived stress and stress-related symptoms.