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Antioxidants as a Treatment and Prevention of Tardive Dyskinesia

  • Vladimir Lerner
Chapter

Abstract

Tardive dyskinesia (TD) is characterized by repetitive, involuntary, purposeless movements of the tongue, lips, face, trunk, and extremities that occur in patients treated with long-term dopaminergic antagonists and following exposure to L-dopa, amphetamine, metoclopramide, cinnarizine, flunarizine and other substances. The term tardive dyskinesia refers to: classical TD (bucco-lingual-masticatory triad), tardive akathisia, tardive dystonia, tardive tremor and other tardive extrapyramidal subsyndromes. The mechanisms of TD remain unclear, although pathophysiologic theories have proposed mechanisms such as dopamine receptor supersensitivity, the degeneration of cholinergic striatal interneurons, γ-aminobutyric acid (GABA) depletion, and an excess of free radicals. Though a wide range of medications for the treatment of TD has been studied, management of this distressful side effect remains a significant problem for patients and a therapeutic conundrum for physicians. According to current concepts, antioxidants such as vitamins and other antioxidative agents may be considered active components of putative therapies because antioxidants inhibit free radical distractive activities. This chapter focuses on evidence from clinical and basic science studies that support the role of antioxidants (vitamins B6 and E, omega-3, ginkgo biloba, piracetam) as potential neuroprotective compounds and effective medications for the prevention and management of TD.

Keywords

Neuroprotection Vitamin B6 Vitamin E Omega-3 Piracetam Ginkgo biloba Schizophrenia Tardive dyskinesia Clinical trials 

Abbreviations

5-HT

Serotonin

AIMS

Abnormal involuntary movement scale

BPRS

Brief psychiatric rating scale

CNS

Central nervous system

ESRS

Extrapyramidal symptom rating scale

FGAs

First-generation antipsychotics

GABA

Gamma-aminobutyric acid

IU

International unit

PANSS

Positive and negative syndrome scale

SGAs

Second generation agents

TD

Tardive dyskinesia

Notes

Acknowledgements

The vitamin B6 and piracetam studies performed by our research group were supported by grants (02T-125 and 02T-235) from the Stanley Foundation.

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© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Division of Psychiatry, Ministry of HealthBe’er Sheva Mental Health CenterBe’er ShevaIsrael
  2. 2.Faculty of Health SciencesBen-Gurion University of the NegevBe’er ShevaIsrael

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