Abstract
Tardive dyskinesia has been hypothesized to be caused by a neuroleptic-induced dopamine hypersensitivity in the nigrostriatal system. This study evaluated with dopamine antagonists the possibility that such dopamine hypersensitivity extends to the tuberoinfundibular dopamine (TIDA) system, which regulates, by inhibition, pituitary prolactin secretion. Plasma prolactin concentrations in six patients with tardive dyskinesia were asessed in four conditions: During chronic haloperidol therapy; serially after abrupt haloperidol withdrawal; while unmediated; and in response to an acute dose of 0.5 mg IM haloperidol. In all four conditions, prolactin responses did not differ from those observed in normal subjects and schizophrenic patients without tardive dyskinesia. It is concluded that there is no evidence for post-synaptic dopamine hypersensitivity in the TIDA-pituitary pathway in patients with tardive dyskinesia, consistent with other reports assessing hormonal responses to dopamine agonists in such cases. It is further suggested that neuroleptic-induced dopamine hypersensitivity does not occur in the TIDA-pituitary system in humans, since it was not manifest in these tardive dyskinesia patients who would be thought particularly prone to develop it.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Angrist, B., Ain, M., Rotrosen, J., Gershon, S., Halpern, F. S., Sachar, E.J.: Behavioral and neuroendocrine effects of low dose ET-495: Antagonism by haloperidol. J. Neurotransm. in press (1979)
Carlsson, A.: Biochemical implications of dopa-induced action on the central nervous system with particular reference to abnormal movements. In: L-Dopa and parkinsonism, A. Barbeau, F. H. McDowell, eds. pp. 205–212. Philadelphia: Davis 1970
Carlsson, A.: Mechanism of action of neuroleptic drugs. In: Psychopharmacology: A generation of progress. M. A. Lipton, A. Dimascio, K. F. Killam, eds., pp. 1057–1070. New York: Raven 1978
Casey, D. E., Denney, D.: Pharmacological characterization of tardive dyskinesia. Psychopharmacology 54, 1–8 (1977)
Ettigi, P., Nair, N. P. V., Lal, S., Cervantes, P., Guyda, H.: Effect of apomorphine on growth hormone and prolactin secretion in schizophrenic patients, with or without oral dyskinesia, withdrawn from chronic neuroleptic therapy. J. Neurol. Neurosurg. Psychiatry 39, 870–876 (1976)
Frantz, A. G.: Prolactin. N. Engl. J. Med. 298, 201–207 (1978)
Friend, W. C., Brown, G. M., Lee, T., Seeman, P.: Neuroleptic receptors in pituitary and striatum. Paper read at the Annual Meeting of the American Psychiatric Association, Toronto, Ontario, May, 1977
Gruen, P. H., Sachar, E. J., Langer, G.: Prolactin responses to neuroleptics in normal and schizophrenic subjects. Arch. Gen. Psychiatry 35, 108–116 (1978)
Klawans, H. L.: The pharmacology of tardive dyskinesia. Am. J. Psychiatry 130, 82–86 (1973)
Langer, G., Sachar, E. J., Halpern, F. S., Gruen, P. H., Solomon, M.: The prolactin response to neuroleptic drugs: A test of dopaminergic blockade. Neuroendocrine studies in normal men. J. Clin. Endocrinol. Metab. 45, 996–1002 (1977)
Meltzer, H. Y., Goode, D. J., Fang, S. V., Schyve, P., Young, M.: Dopamine and schizophrenia. Lancet 1976II, 1142
Meltzer, H. Y., Sachar, E. J., Frantz, A. G.: Serum prolactin levels in unmedicated schizophrenic patients. Arch. Gen. Psychiatry 31, 564–569 (1974)
Muller, P., Seeman, P.: Dopaminergic supersensitivity after neuroleptics: Timecourse and specificity. Psychopharmacology 60, 1–11 (1978)
National Institute of Mental Health, Psychopharmacology Research Branch: Development of a dyskinetic movement scale. Early Clinical Drug Evaluation Unit Intercom 4, 3–6 (1975)
Pandey G. N., Garver, D. L., Tamminga, C., Ericksen, S., Ali, S. I., Davis, J. M.: Post-synaptic supersensitivity in schizophrenia. Am. J. Psychiatry 134, 518–522 (1977)
Sinha, Y. N., Selb, F. W., Lewis, U. J., van der Laan, W. P.: A homologous radioimmunoassay for human prolactin. J. Clin. Endocrinol. Metab. 36, 509–516 (1973)
Smith, R. C., Tamminga, C. A., Haraszti, J., Pandey, G. N., Davis, J. M.: Effects of dopamine agonists in tardive dyskinesia. Am. J. Psychiatry 134, 763–768 (1977)
Spitzer, R. L., Endicott, J., Robins, E.: Research diagnostic criteria (RDC). Psychopharmacol. Bull. 11, 22–24 (1975)
Tamminga, C. A., Smith, R. C., Pandey, G., Frohman, L. A., Davis, J. M.: A neuroendocrine study of supersensitivity in tardive dyskinesia. Arch. Gen. Psychiatry 34, 1199–1203 (1977)
Tarsy, D., Baldessarini, R. J.: The tardive dyskinesia syndrome. In: Clinical neuropharmacology, vol. 1, H. L. Klawans, ed., pp. 29–62. New York: Raven 1976
Walters, J. R., Bunney, B. S., Roth, R. H.: Piribedil and apomorphine pre- and post-synaptic effects of dopamine synthesis and neurological activity. In: Advances in neurology, vol. 9, D. B. Calne, T. N. Chase, A. Barbeau, eds., pp. 273–284. New York: Raven 1975
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Asnis, G.M., Sachar, E.J., Langer, G. et al. Normal prolactin responses in tardive dyskinesia. Psychopharmacology 66, 247–250 (1979). https://doi.org/10.1007/BF00428314
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00428314