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Antioxidants as a Treatment and Prevention of Tardive Dyskinesia

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Handbook of Schizophrenia Spectrum Disorders, Volume III

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.

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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

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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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  1. Division of Psychiatry, Ministry of Health, Be’er Sheva Mental Health Center, Be’er Sheva, Israel

    Vladimir Lerner

  2. Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel

    Vladimir Lerner

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Correspondence to Vladimir Lerner .

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  1. , Rappaport Faculty of Medicine, Technion - Israel Institute of Technolog, Haifa, Israel

    Michael S. Ritsner

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Lerner, V. (2011). Antioxidants as a Treatment and Prevention of Tardive Dyskinesia. In: Ritsner, M. (eds) Handbook of Schizophrenia Spectrum Disorders, Volume III. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-0834-1_6

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