Tics Appearing After Years Of Schizophrenia - Medication or Illness?

Hi. First post here so hopefully I’m in right category etc. Actually just copying this over from other site where I accidentally posted.

Writing regarding my younger brother who has had schizophrenia since he was 17 and is now 44. Technically he is diagnosed with untreatable schizophrenia which I guess means no real chance of leading a normal life, marriage, work and so on. As a family we look after him and he lives with my Mum. He doesn’t really accept he is ill but never causes any fuss taking meds and so on. Basically like a big kid frozen at the age he was when he got ill. As heart-breaking as the situation can be for him and us as a family the last couple of years have got worse and can’t help but think the medication is the problem.

As well as suddenly putting on a lot of weight around his belly, largely due to obsessive tea consumption, he has developed 3 different tics that on certain days he does almost constantly. A strange laugh, compulsive scratching of any surface he is near and pulling quite an aggressive face whilst doing it. He lives in a pretty rough area and am really scared that these tics are going to get him assaulted sooner of later.

Which I guess leads to my question. Does anyone have any experience of tics developing later in the illness, pretty much from nowhere. Is it likely to be his medication, Clozapine, or the schizophrenia itself? Any views, advice or shared experiences greatly welcomed.

Just as a last additional bit of info. He was on Clozapine for years but out of the blue was diagnosed with Primary Immunodeficiancy and kept failing the light system blood tests thing you need to take - either because of the PID or just coincidence. This led to him going into Olanzapine about 3 years ago, then a couple of years ago back on Clozapine which he has been on since. Tics started about a year ago and gradually getting worse.


Hello, there are serious side effects to the medications. One is called Tardive dyskinesia and Extrapyramidal symptoms. Please review theses and ask his medical doctor about his tic’s. Clozapine can cause a reduction of white blood cells which will lead to immunodeficiency issues. More side effects are increased blood sugar which can lead to diabetes, high cholesterol levels which can lead to heart disease, and severe weight gain. You’re right for thinking the medications are causing some changes. I hope you can discuss this with his doctor.

This article says there are meds to treat extrapyramidal symptoms: Treatment recommendations for extrapyramidal side effects associated with second-generation antipsychotic use in children and youth.

This article says treatment might be possible (mentions benzodiazepines), but prefers lowering the dosage or changing meds: Extrapyramidal Side Effects From Medication

Benzos have to be used with caution, IMO, because they quickly build up tolerance and dependency.

Thank you very much for reply. Very helpful and good to have the medical definitions of what is happening. It definitely seems like Tardive Dyskinesia. His current NHS doctor has said historically his Clozapine dosage - prior to the break for Olzapine - and the amount he is on now is fairly low and that upping it might help with the tics. It seems a real catch 22 as it could just as equally be causing the problem.
Clozapine has always seemed to have the best effect on the more positive symptoms (can’t remember if that is the right term) of his schizophrenia but the negative symptoms such as withdrawal, lack of interest in anything and so on have never improved and arguably got worse with it. My understanding is it is still the best treatment available though.

Really helpful articles. Thanks

I think we will get his Doctor to do an assessment for EPS as suggested in your second link.

Have a feeling he is on a low dosage of anti-depressants as well which wasn’t for depression but to deal with some of the negative symptoms of schizophrenia. Might be that is causing issues as well.