Natural Treatments for Tardive Dyskinesia: What’s Worth Trying?

Once you’ve been diagnosed with tardive dyskinesia (TD) — a movement disorder that develops weeks, months or even years after starting a class of medications called dopamine antagonists — your healthcare team has some important treatment decisions to make.

“First, we have to identify the medication that’s causing your TD,” neurologist Hubert Fernandez, MD, explains. “If your doctor thinks you can safely reduce the dose or get rid of the medication, that’s the best path. And it’s sometimes doable. In other cases, your specialist can prescribe different medicines — medicines that don’t cause TD.”

In an ideal world, that’d be the end of the story. The involuntary movements stop. But we don’t live in an ideal world. Not everybody’s able to switch or reduce their medications safely. And those who do sometimes find that their tardive dyskinesia doesn’t go away. At that point, it’s time to consider some other options.

The U.S. Food and Drug Administration (FDA) now has two approved drugs available for counteracting tardive dyskinesia: deutetrabenazine and valbenazine. But as with everything else in TD, your mileage may vary. The drugs work well for some, while others experience partial or no benefit from them.

But Dr. Fernandez isn’t about to give up.

“This is when we become creative and think of natural remedies and add-on therapies that we can use,” he says. He explains the state of the research on vitamins and supplements as TD treatments and offers advice for experimenting safely.

Natural treatments for tardive dyskinesia

As with most medical conditions, an internet search will yield a long list of vitamins and supplements that people claim reduce or eliminate TD symptoms. But the truth is a bit more complicated.

While the exact cause of tardive dyskinesia remains a mystery, some experts believe dopamine antagonists supercharge the production of free radicals in the brain. Antioxidants like vitamin B6, vitamin E and ginkgo biloba pick off free radicals, which both stop cell damage as it’s happening and protect against future oxidative stress. If you subscribe to this theory, those three supplements make sense as a complement to prescription TD treatments.

But (there’s always a but)...

“The cumulative evidence we have on these natural remedies is not that impressive,” Dr. Fernandez states. “When you group all the studies together and do a meta-analysis, the bottom line is that they either don’t work or they only have a small impact.”

But — Dr. Fernandez is quick to add — that doesn’t mean these treatments never work for anybody. A meta-analysis averages out several studies, so chances are good the supplement worked for some people. And you can’t know if you’d be in that lucky group unless you give it a shot.

“The good news is these natural treatments are generally safe when taken as directed,” he says. “The worst thing that’s going to happen is that a supplement doesn’t work and you waste your money. But the best thing that could happen is that it actually gets you the relief you need.”

Which of the natural remedies that you see online are worth trying? According to Dr. Fernandez, the most promising — and lowest risk — options are vitamin B6, vitamin E and ginkgo biloba.

“With these supplements, there’s less to lose and more to gain, so I wouldn’t object to somebody using them,” he continues. But he still recommends speaking with your TD specialist before experimenting with natural treatments, as these supplements can cause drug interactions.

Vitamin B6

Vitamin B6 (pyridoxine) is a water-soluble vitamin that plays an important role in creating and processing neurotransmitters like serotonin and dopamine. It’s also a powerful antioxidant. That’s a TD double whammy. In fact, one 2008 study of antipsychotic-induced TD found that their participants had lower than average pyridoxine levels.

People with adequate access to food rarely experience B6 deficiency. It occurs naturally in a lot of the food we eat — and it’s often added to foods to improve their nutritional value.

Several case studies and small-scale clinical trials suggest B6 may reduce symptoms. And a 2015 meta-review found a possible benefit to high-dose B6 therapy in people living with schizophrenia who have tardive dyskinesia. But the researchers clarified that the evidence is still lacking because the studies in question were small and imperfectly executed.

So far, studies of high-dose pyridoxine therapy for TD haven’t reported any significant side effects. But according to the U.S. National Institutes of Health (NIH), taking high doses of B6 for an extended period can cause a wide range of side effects. It can even cause nerve damage and — of all things — loss of control of bodily movement. Your healthcare provider can determine a safe dose for you and monitor you for vitamin B6 toxicity.

Vitamin E

Vitamin E is a fat-soluble compound that is chock full of antioxidants. Like vitamin B6, most people with access to nutritious food get all the vitamin E they need. But people living with TD may benefit from adding a supplement to their regimen. The “may” in that last sentence is important. There’s not much research on the topic. And the research we do have isn’t definitive.

A 2018 meta-analysis found that while it may protect against further deterioration, vitamin E did not improve symptoms in people with antipsychotic-induced TD. It also noted that the existing studies on the topic were both small and poorly designed. Meanwhile, a more recent meta-analysis looked at 18 studies. It concluded that vitamin E did decrease symptoms.

Like vitamin B6, you have to be careful about dosing when you take vitamin E. A 2018 case report pointed out that high-dose vitamin E therapy has been associated with an increased risk of certain vascular diseases and cancers. Dr. Fernandez recommends asking your provider about the risks and benefits of adding vitamin E therapy to your TD toolkit before adding it to your pill case.

Ginkgo biloba

Ginkgo biloba has been a part of traditional Chinese medicine (TCM) for thousands of years. It has both antioxidant and anti-inflammatory properties, which has long made it a favorite (but controversial) natural remedy for dealing with age-related concerns like cognitive decline, degenerative eye disease, heart health and cancer prevention.

The science supporting the use of ginkgo biloba for TD symptoms is pretty consistently positive, but the studies themselves leave something to be desired. A 2023 study, for example, found ginkgo to be an effective and safe treatment for people who have TD and psychotic or mood-related disorders, but there were only 63 study participants.

A 2016 meta-analysis out of China yielded similarly positive findings but the authors only analyzed data from three randomized controlled trials. The researchers made clear that much more research is needed before it’s safe to assume ginkgo biloba is an effective and safe treatment for TD.

Ginkgo biloba is usually safe when taken as directed, but it can have unpleasant side effects. And it’s potentially dangerous if you’re pregnant, breastfeeding (chestfeeding), taking blood thinners (anticoagulants) or have a blood disorder. Talk to your TD specialist before starting a ginkgo biloba regimen to be sure it won’t interfere with other medications you’re taking.

How to use supplements safely

While vitamin B6, vitamin E and ginkgo biloba are all safe in theory, it’s important to remember that product choice matters. Supplements aren’t regulated by the FDA. And pretty much anybody can manufacture them.

“You’re depending on the integrity and the high standards of that entrepreneur, the maker of the natural product that you’re ingesting,” Dr. Fernandez says. “You don’t know if a pill marketed as having 100 milligrams (mg) of vitamin B6 actually has 100 milligrams. It could have 250 mg, 50 mg, 1,000 mg. And you don’t know if they mixed something else in there either. You have to be very careful.”

That means only buying supplements that went through independent third-party testing. Check to see if a product you’re considering has a Certificate of Analysis (COA) to that effect.

The bottom line

There isn’t any scientific proof that natural remedies can effectively treat or reduce symptoms of tardive dyskinesia. The research that does exist has been underwhelming. But there are still some people who’ve benefitted from their use. The lowest risk, highest possible reward options are vitamin B6, vitamin E and ginkgo biloba.

Be sure to speak to your healthcare provider before adding any of these supplements to your daily routine. They’ll check to confirm the dosage is safe, and that the supplement won’t interact with medications you’re already taking.

And remember: Supplements aren’t regulated by the FDA, so it’s best to buy high-quality products that have been evaluated via third-party testing. It’s still possible you’ll see no effect, but at least you’ll know the products you’re putting in your body are safe.