Tardive dyskinesia on the newer antipsychotics: 21 percent across 41 studies, 7 percent if never on an older drug
"Rates were lower with current SGA treatment (20.7%) vs current FGA treatment (30.0%)." In people who had never taken an older antipsychotic, prevalence was 7.2 percent.
Reasonable evidence with real limitations. how we score evidence
Caveat on this rating: Cross-sectional prevalence, not incidence, and heavily confounded by prior exposure to older drugs, age and illness duration, which the authors model. Severity was not analysable. Prevalence on a rating scale overstates clinically disabling TD.
The second-generation antipsychotics were expected to cause far less tardive dyskinesia, the involuntary movements the older drugs were known for. This is the count of how that went.
Significant findings
Carbon, Hsieh, Kane and Correll (Journal of Clinical Psychiatry, 2017) pooled 41 studies with 11,493 patients that measured tardive dyskinesia (TD) with a rating scale. "The global mean TD prevalence was 25.3%". "Rates were lower with current SGA treatment (20.7%; 95% CI = 16.6%-25.4%, N = 5,103) vs current FGA treatment (30.0%; 95% CI = 26.4%-33.8%, N = 5,062)".
Most people on a newer drug had taken an older one first. Where they had not: "Particularly low TD prevalence (7.2%; number of studies = 4) was found in the treatment arms with FGA-naive subjects relative to SGA-treated cohorts with likely prior FGA exposure (23.4%; P < .001; 28 studies)".
The authors' conclusion: "Rating scale-based TD remains highly prevalent, with higher rates during FGA than during SGA treatment. However, TD severity was insufficiently reported to allow for interpretation of the clinical impact of identified TD cases".
Worth asking
Both readings are in the paper. The newer drugs are better on this measure, and much better in people never exposed to the older ones. They did not make the problem go away. Two drugs now exist to treat TD, valbenazine and deutetrabenazine; in 2024 psychiatrists alone wrote 84,402 Medicare prescriptions for them at a cost of $647 million, and they are among the products most attached to industry speaker fees. A rating scale finding is not the same as a disabling movement disorder, and the paper could not say how many of these cases were severe. If you take an antipsychotic, ask whether anyone is checking you for abnormal movements and how often. Never stop one on your own.
Source
Tardive Dyskinesia Prevalence in the Period of Second-Generation Antipsychotic Use: A Meta-Analysis — Carbon M, Hsieh CH, Kane JM, Correll CU (2017)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.4088/JCP.16r10832
DOI: 10.4088/JCP.16r10832
How this was scored
- Study design
- Systematic review of observational studies
- Funding
- Funding not disclosed
- Published in
- Reputable peer-reviewed journal
- Sample size
- 11,493
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 21, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "moderate evidence". Reasonable evidence with real limitations. It scores 59 out of 100 on our published rubric. One caveat travels with that badge: Cross-sectional prevalence, not incidence, and heavily confounded by prior exposure to older drugs, age and illness duration, which the authors model. Severity was not analysable. Prevalence on a rating scale overstates clinically disabling TD. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Tardive Dyskinesia Prevalence in the Period of Second-Generation Antipsychotic Use: A Meta-Analysis — Carbon M, Hsieh CH, Kane JM, Correll CU (2017). Published in: Reputable peer-reviewed journal. DOI: 10.4088/JCP.16r10832. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Systematic review of observational studies. Funding: Funding not disclosed. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.