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Attempts at Pharmacological Management of Tardive Dyskinesia

  • William E. Fann
  • John M. Davis
  • Ian C. Wilson
  • C. Ray Lake
Part of the Advances in Behavioral Biology book series (ABBI, volume 6)

Abstract

One of the more perplexing side-effects of drug therapy, first described by Sigwald and coworkers (34) in 1959, and now generally known as tardive dyskinesia (TD), a hyperkinetic state secondary to prolonged exposure to neuroleptics (2, 7, 8, 9), has proven difficult to treat pharmacologically. A variety of agents has been used in attempts at reversing it. Patients most likely to evince TD are those withdrawn, after long exposure, from neuroleptics; continued therapy tends to mask or reduce the symptoms (10,11). On this evidence, some investigators have tried high doses of phenothiazines, especially the piperazine derivatives (5, 35, 4), as well as haloperidol (33, 24), in treating these conditions. The rationale for using these agents is that they block activity of dopamine (DA) in the CNS and, since TD may be due to DA over-activity at certain striatal neurons, reducing the effect of DA should cause a diminution of the abnormal movements. The short-term efficacy of these agents suggests that this reasoning is correct. However, methyldopa, a compound known to compete with DA in vitro and a commonly used antihypertensive, did not show any clear effect in relieving symptoms of TD (23). Others have tried the potent biogenic amine depleting agent, reserpine (30,32) and its congener, tetrabenzine (19), with some success. Amantadine, an anti-viral agent with mild CNS stimulant properties, has also been suggested (36), but the findings from these investigations, and even the criteria used in them for TD, have been challenged (12). The vitamin pyridoxine has been tried, also without success (13), and levodopa, a precursor of dopamine used successfully in treating Parkinsonism has provided no help in TD (24).

Keywords

Tardive Dyskinesia Involuntary Movement Pharmacological Management Central Stimulant Dopaminergic Mechanism 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Plenum Press, New York 1973

Authors and Affiliations

  • William E. Fann
  • John M. Davis
  • Ian C. Wilson
  • C. Ray Lake

There are no affiliations available

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