Tardive dyskinesia: reversible and irreversible
- PMID: 2860664
- DOI: 10.1007/978-3-642-70140-5_11
Tardive dyskinesia: reversible and irreversible
Abstract
The long-term prognosis of tardive dyskinesia (TD) has been insufficiently studied. Symptoms are reversible in many patients, but an irreversible course is widely believed to be the expected outcome. This pessimistic view has led to the assumption that neuroleptics should not be used in patients with TD because these drugs will produce an inevitable aggravation of TD. To clarify this issue, 27 patients were serially evaluated over 5 years for changes in neuroleptic treatment, TD, and mental status. Ten patients were able to discontinue medications; 15 required continued low-dose neuroleptic therapy [average 223 mg/day chlorpromazine (CPZ) equivalents], and two needed high doses (1000-2000 mg/day CPZ equivalents) to control psychosis. The majority of patients improved by more than 50% in both treated and untreated groups. In 8 of 27 patients (29.6%) TD resolved; in 1 patient TD increased by 25%. Younger patients improved the most. Prognosis was most favorable if neuroleptics were discontinued, but improvement was still possible with low to moderate doses (less than 600 mg/day CPZ equivalents). The large majority of patients with schizophrenia or schizoaffective illness relapsed, and required continued drug treatment. TD must be evaluated over several years to monitor the resolving/persisting course. Control of psychosis and improvement of TD during low-dose neuroleptic treatment suggest the antipsychotic and neurological effects of neuroleptics may involve different thresholds or mechanisms of action.
Similar articles
-
Neuroleptic reduction and/or cessation and neuroleptics as specific treatments for tardive dyskinesia.Cochrane Database Syst Rev. 2000;(2):CD000459. doi: 10.1002/14651858.CD000459. Cochrane Database Syst Rev. 2000. Update in: Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000459. doi: 10.1002/14651858.CD000459.pub2. PMID: 10796546 Updated. Review.
-
Predictors of improvement in tardive dyskinesia following discontinuation of neuroleptic medication.Br J Psychiatry. 1990 Oct;157:585-92. doi: 10.1192/bjp.157.4.585. Br J Psychiatry. 1990. PMID: 1983390
-
Neuroleptic reduction and/or cessation and neuroleptics as specific treatments for tardive dyskinesia.Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000459. doi: 10.1002/14651858.CD000459.pub2. Cochrane Database Syst Rev. 2006. Update in: Cochrane Database Syst Rev. 2018 Feb 06;2:CD000459. doi: 10.1002/14651858.CD000459.pub3. PMID: 16437425 Updated. Review.
-
Tardive dyskinesia presenting as a psychosis.J Nerv Ment Dis. 1979 Dec;167(12):762-3. doi: 10.1097/00005053-197912000-00009. J Nerv Ment Dis. 1979. PMID: 41884
-
Neuroleptic withdrawal in treatment-resistant patients with schizophrenia: tardive dyskinesia is not associated with supersensitive psychosis.Schizophr Res. 2003 Sep 1;63(1-2):151-60. doi: 10.1016/s0920-9964(02)00338-9. Schizophr Res. 2003. PMID: 12892869
Cited by
-
Effect of alpha lipoic acid on the tardive dyskinesia and oxidative stress induced by haloperidol in rats.J Neural Transm (Vienna). 2009 Jul;116(7):807-14. doi: 10.1007/s00702-009-0232-y. Epub 2009 May 15. J Neural Transm (Vienna). 2009. PMID: 19444377
-
Tardive dyskinesia.West J Med. 1990 Nov;153(5):535-41. West J Med. 1990. PMID: 1979705 Free PMC article. Review.
-
Resveratrol Protects Against Vacuous Chewing Movements Induced by Chronic Treatment with Fluphenazine.Neurochem Res. 2017 Nov;42(11):3033-3040. doi: 10.1007/s11064-017-2335-4. Epub 2017 Jul 25. Neurochem Res. 2017. PMID: 28744755
-
Tardive dyskinesia: therapeutic options for an increasingly common disorder.Neurotherapeutics. 2014 Jan;11(1):166-76. doi: 10.1007/s13311-013-0222-5. Neurotherapeutics. 2014. PMID: 24310603 Free PMC article.
-
Diphenyl diselenide decreases the prevalence of vacuous chewing movements induced by fluphenazine in rats.Psychopharmacology (Berl). 2007 Oct;194(3):423-32. doi: 10.1007/s00213-007-0831-y. Epub 2007 Jul 20. Psychopharmacology (Berl). 2007. PMID: 17641876
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Medical