What Meds Cause Lip Twitching?: A Guide to Medication-Induced Dyskinesia

October 11, 2025 •

4 min read

Did you know that antipsychotic and anti-nausea medications, used over time, can cause a serious condition called tardive dyskinesia, which manifests as involuntary facial movements like lip twitching? Understanding which meds cause lip twitching is vital for monitoring side effects and informing your doctor.

Quick Summary

Lip twitching can be an extrapyramidal side effect of various drugs, notably antipsychotics and certain antidepressants, often caused by long-term use. The involuntary movement is frequently a symptom of tardive dyskinesia.

Key Points

Antipsychotics are a Primary Cause: Older (first-generation) and newer (second-generation) antipsychotics are a common cause of drug-induced movement disorders, including lip twitching.
Tardive Dyskinesia Can Develop over Time: The side effect often develops after months or years of use and can sometimes be permanent if not addressed early.
Antidepressants and Mood Stabilizers Pose a Risk: Certain types of antidepressants, including SSRIs and TCAs, along with mood stabilizers like lithium, have also been linked to facial tics and movement disorders.
Anti-Nausea Drugs are Implicated: Antiemetics like metoclopramide and prochlorperazine can cause acute dystonic reactions and are associated with tardive dyskinesia risk.
Stimulants can Trigger or Worsen Tics: Medications for ADHD, particularly stimulants, can sometimes exacerbate tics, including those involving the facial muscles.
Prompt Medical Consultation is Crucial: If you experience involuntary movements, consult your doctor. They may adjust your medication, monitor symptoms, or prescribe alternative treatments.
Do Not Stop Medication Abruptly: Never stop or change your medication dosage without first speaking to your doctor, as it can lead to dangerous withdrawal symptoms.

Understanding Drug-Induced Movement Disorders

Medication-induced movement disorders are a class of conditions that can arise as a side effect of certain pharmaceuticals. The most well-known of these, and the one most associated with involuntary facial movements like lip twitching, is tardive dyskinesia (TD). The term "tardive" means delayed, indicating that the symptoms can develop after months or even years of medication use, or sometimes after the medication is stopped. "Dyskinesia" refers to abnormal, involuntary, repetitive muscle movements. TD is linked to long-term use of drugs that block dopamine receptors in the brain.

Another type of drug-induced movement disorder is acute dystonia, which involves involuntary muscle contractions that cause twisting and repetitive movements or abnormal postures. While this is often an acute reaction, it can sometimes affect the face and mouth, though typically it occurs sooner after starting a medication than TD.

Antipsychotic Medications and Lip Twitching

Antipsychotics are a primary cause of TD, as they work by blocking dopamine receptors in the brain. There are two main types of antipsychotics, with different risk levels for causing TD.

First-Generation (Typical) Antipsychotics

Older, or first-generation, antipsychotics carry a higher risk of causing movement disorders. This is because they have a stronger, more generalized effect of blocking dopamine receptors. Examples of these include:

Haloperidol (Haldol)
Chlorpromazine (Thorazine)
Prochlorperazine (Compro), also used for nausea
Fluphenazine
Pimozide

Second-Generation (Atypical) Antipsychotics

Newer, or second-generation, antipsychotics have a lower risk of causing TD, but the risk is still present. These medications block dopamine receptors in a more specific way than their older counterparts. However, long-term use still presents a risk. Examples include:

Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
Aripiprazole (Abilify)

Antidepressants and Mood Stabilizers

While most associated with antipsychotics, movement disorders like TD can also be caused by some antidepressants and mood stabilizers, particularly with long-term use.

Selective Serotonin Reuptake Inhibitors (SSRIs): Some SSRIs, like escitalopram, have been linked to involuntary facial movements, including hemifacial spasm. Other SSRIs like fluoxetine have also been implicated.
Tricyclic Antidepressants (TCAs): TCAs such as amitriptyline and doxepin have been reported to cause movement disorders.
Mood Stabilizers: Medications like lithium are associated with an increased risk of TD, especially in older adults.

Other Drug Classes

Several other types of medications have been linked to lip twitching and other involuntary movements, often as a side effect known as extrapyramidal symptoms or drug-induced dystonia.

Antiemetic (Anti-Nausea) Medications: Drugs such as metoclopramide and prochlorperazine, which are used to manage nausea and vomiting, can cause acute dystonic reactions and sometimes contribute to TD.
Stimulant Medications: Used for ADHD, stimulants like methylphenidate (Ritalin) and amphetamine can sometimes trigger or worsen tics, which can include facial movements like lip twitching. The association is complex, with some studies showing no link, while others suggest a potential for exacerbation.
Anticonvulsants: Certain seizure medications, such as carbamazepine and lamotrigine, have been reported to induce tics or other involuntary movements in some patients.

What to do if you experience symptoms

If you experience lip twitching or other involuntary movements, it is important to communicate with your healthcare provider. A doctor may use a rating scale, such as the Abnormal Involuntary Movement Scale (AIMS), to assess and track the severity of your symptoms. Adjusting the dosage or switching to a different medication may help alleviate the side effect. In the case of established tardive dyskinesia, your doctor may prescribe specific medications, known as VMAT2 inhibitors (e.g., Ingrezza, Austedo), that are approved by the FDA for the treatment of TD.


Medication Class	Example Medications	Associated Movement Disorder	Key Features
First-Generation Antipsychotics	Haloperidol, Chlorpromazine	Tardive Dyskinesia	High risk, long-term use, includes lip smacking, grimacing
Second-Generation Antipsychotics	Risperidone, Olanzapine	Tardive Dyskinesia	Lower but present risk, long-term use, includes lip pursing
Antiemetics	Metoclopramide, Prochlorperazine	Acute Dystonia, Tardive Dyskinesia	Can cause acute reactions or, with long-term use, TD
SSRIs	Escitalopram, Fluoxetine	Hemifacial Spasm, TD (rare)	Case reports of reversible facial spasms; TD potential
Tricyclic Antidepressants	Amitriptyline, Doxepin	Tardive Dyskinesia	Long-term use linked to risk, similar to antipsychotics
Mood Stabilizers	Lithium	Tardive Dyskinesia	Increased risk, especially in older adults
Stimulants	Methylphenidate, Amphetamine	Tics	Can trigger or worsen existing tics, though often a temporary effect

Conclusion

Lip twitching as a side effect of medication can be unsettling, but it is often manageable with proper medical guidance. A number of drug classes, from first-generation antipsychotics to certain antidepressants and anti-nausea drugs, can contribute to this involuntary movement, sometimes as a symptom of tardive dyskinesia. The risk can be influenced by dosage, duration of use, and individual factors. If you notice involuntary facial movements, it's crucial to consult your doctor. In many cases, adjusting the treatment plan can reduce or eliminate the symptoms. Never stop a prescribed medication abruptly without medical consultation, as it can be dangerous and sometimes worsen symptoms. Open communication with your healthcare provider is the most effective way to address this side effect and ensure safe, effective treatment. For more information, the National Alliance on Mental Illness (NAMI) provides comprehensive resources on tardive dyskinesia.

Visit the NAMI website for more information on tardive dyskinesia.

Frequently Asked Questions

Tardive dyskinesia (TD) is a drug-induced movement disorder that causes involuntary, repetitive muscle movements, especially in the face. Lip twitching, smacking, or pursing are common symptoms of TD, which typically occurs after prolonged use of certain medications, particularly antipsychotics.

Common medications known to cause lip twitching include older antipsychotics like haloperidol, some newer antipsychotics like risperidone, certain antidepressants (SSRIs, TCAs), and anti-nausea drugs like metoclopramide.

Not necessarily. Acute dystonic reactions, which can cause facial muscle spasms, are often temporary and resolve after discontinuing the offending drug. However, tardive dyskinesia can become permanent if not treated in its early stages.

Yes, some antidepressants, including SSRIs and tricyclic antidepressants, have been linked to movement disorders like tardive dyskinesia or hemifacial spasm in some patients, though it is a less common side effect than with antipsychotics.

You should contact your doctor immediately. Do not stop taking the medication abruptly. Your doctor can assess your symptoms, determine if the medication is the cause, and decide on the best course of action, which may include adjusting the dose or switching to a different drug.

Yes. Some anti-nausea drugs, or antiemetics, particularly metoclopramide and prochlorperazine, can cause acute dystonic reactions or, with prolonged use, tardive dyskinesia.

Doctors diagnose drug-induced movement disorders by taking a detailed patient history, performing a physical examination, and using specialized rating scales like the Abnormal Involuntary Movement Scale (AIMS) to track the severity of the involuntary movements over time.