JOY ANTONELLE DE MARCAIDA: Good to see you, Brian. I am good.
BRIAN SMUDA: So I think we were just talking about my tardive dyskinesia, and how it affects life, and the way it works.
JOY ANTONELLE DE MARCAIDA: Yes. I think that it's important for people to understand how tardive dyskinesia is manifest, and whether there are treatment options that we can offer.
BRIAN SMUDA: Certainly. I mean, the symptoms leading up to it were kind of minor at first. They started up in the jerky neck for me. Just the-- the pulling of the neck was the first sign, where I should have been like, hey, check this out. But I kind of ran with it for a while. And then it spread throughout the body.
JOY ANTONELLE DE MARCAIDA: Yes. And I think that what you're pointing out is that the symptoms can change over time. And it could manifest in different ways.
BRIAN SMUDA: Right.
JOY ANTONELLE DE MARCAIDA: In your case, Brian, the TD was pretty intense, I remember.
BRIAN SMUDA: It was a very dark point in my life, because the little twitches that are going on right now would happen where you're just flat out on the floor.
JOY ANTONELLE DE MARCAIDA: You had the form that was primarily generalized dystonia. So some people have oro-bucco-lingual dyskinesias, where it's really just around the mouth and the tongue that they have movements. But when you have generalized dystonia like you did, it is completely debilitating.
BRIAN SMUDA: Yeah.
JOY ANTONELLE DE MARCAIDA: I think it's important to point out that tardive dyskinesias is always related to the use of certain medications. We call it an iatrogenic disease, where it is caused by something that, uh, medical professionals are doing. And in this particular case, it is a side effect of certain medications usually used to treat schizophrenia.
BRIAN SMUDA: Right.
JOY ANTONELLE DE MARCAIDA: In your case, you were taking those medications for Turret's syndrome.
BRIAN SMUDA: All 11 of 'em.
JOY ANTONELLE DE MARCAIDA: And all of these medications were dopamine receptor blocking agents. Some of the research has suggested that just taking multiple dopamine receptor blocking agents, or taking them for a long period of time, increases the risk of developing tardive dyskinesias.
BRIAN SMUDA: And there's actually, just with medications, a lot of people, in their mind-- I'm twitching. They want to get off immediately, and without contacting their doctor-- a little cold turkey, which you don't want to do. JOY ANTONELLE DE MARCAIDA: Yes. And thank you very much for mentioning that, because one of the things that we really need to emphasize is that when people have tardive dyskinesias, and they know that it may have been caused by one of their medications for schizophrenia, the tendency will be to want to stop their medication right away. And that actually makes it worse.
BRIAN SMUDA: Exactly.
JOY ANTONELLE DE MARCAIDA: So you do not want to just cold turkey stop your antipsychotic. You want to actually slowly taper it off, and that decreases the risk of developing tardive dyskinesias. A lot of times, people cannot come off their antipsychotic medications, because they need it to keep their bipolar disorder under control, their schizophrenia under control.
So if they need it for these other conditions, they absolutely have to continue the medication. And the option for them would be that there are other medications that can be added on to the antipsychotic that they're currently taking to try to decrease the tardive dyskinesias.
BRIAN SMUDA: And another one on that list of ways to help this is actually getting out there, moving. There's, you know, dance treatments, there's yoga treatments, just moving and having a focus on those movements. And just, if you need to slow down for a minute in-- at home and just relax, just breathe. In through the nose, out through the mouth. As simple as that sounds, that can just ease your body, let you sleep, let you relax. And that's something that we don't get all the time having this condition.
JOY ANTONELLE DE MARCAIDA: That's right. You're always an inspiration, Brian. And everything that you do is spot on. So at this time, I think that an emphasis on healthy living, a good attitude-- and although that seems intuitive, a lot of people don't realize that-- that you have to get out there, exercise, do things that you enjoy, live healthy, eat healthy, relax, meditate. And it actually helps with the brain cells.
Brian, you're an inspiration to the community. And I am very happy that this procedure has helped you and that you're doing very well.
BRIAN SMUDA: Thank you very much.
JOY ANTONELLE DE MARCAIDA: It's great to see you.
BRIAN SMUDA: Thank you.