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Two Decades of Experience

Dilip V. Jeste, MD; Richard Jed Wyatt, MD

Arch Gen Psychiatry. 1982;39(7):803-816.

Abstract
• We reviewed 285 treatment studies involving more than 3,000 patients with neuroleptic-induced tardive dyskinesia (TD). Neuroleptic withdrawal is found to reverse dyskinesia in about 37% of patients. There is no satisfactory treatment for persistent TD. Although neuroleptics are significantly superior to most other methods of treatment in suppressing signs of dyskinesia, the safety of their long-term use in dyskinetic patients remains to be demonstrated. Putative β-aminobutyric acid (GABA)—ergic drugs and noradrenergic blockers deserve careful study. A strategy for determining biochemical and pharmacologic subtypes of TD appears promising. The value of the available cholinergic agents in the treatment of TD is uncertain. Caution is warranted in interpreting "positive" results with a number of other drugs, which might act as placebos or as nonspecific sedatives. Anticholinergic drugs are generally not recommended for treating dyskinetic patients. Current theories of the pathophysiology of TD may need revision. Drug-free periods do not seem to prevent TD. Antipsychotic drugs without neuroleptic side effects should be developed.

Author Affiliations
From the Adult Psychiatry Branch, Division of Special Mental Health Research, Intramural Research Program, National Institute of Mental Health, St Elizabeths Hospital, Washington, DC.

Footnotes
Accepted for publication Jan 27, 1982.

Reprint requests to Adult Psychiatry Branch, Division of Special Mental Health Research, National Institute of Mental Health, St Elizabeths Hospital, WAW Building, Washington, DC-20032 (Dr Jeste).

References 41, 43, 45, 50, 52, 54-56, 63, 66, 67, 72.

References 16, 17, 40, 42, 44, 46, 48, 49, 51, 53, 57, 58, 61, 65, 68, 70, 71, 73.

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