This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

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.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Persistent Spontaneous Oral Dyskinesias in Haloperidol-Withdrawn Rats Neonatally Lesioned with 6-Hydroxydopamine: Absence of an Association with the Bmax for [3H]Raclopride Binding to Neostriatal Homogenates
Huang et al.
J. Pharmacol. Exp. Ther. 1997;280:268-276.
ABSTRACT | FULL TEXT  

Risks of Withdrawing Antipsychotic Medications
Wyatt
Arch Gen Psychiatry 1995;52:205-208.
ABSTRACT  

Progress in Psychiatry
Fleck et al.
NEJM 1994;330:285-286.
FULL TEXT  

Psychiatric Uses of Anticonvulsants
Dorson
Journal of Pharmacy Practice 1990;3:262-275.
ABSTRACT  

Treatment of Tardive Dyskinesia With Bromocriptine: A Test of the Receptor Modification Strategy
Lieberman et al.
Arch Gen Psychiatry 1989;46:908-913.
ABSTRACT  

Who Should Receive Clozapine?
Marder and Van Putten
Arch Gen Psychiatry 1988;45:865-867.
ABSTRACT  

Cognitive Dysfunction, Negative Symptoms, and Tardive Dyskinesia in Schizophrenia: Their Association in Relation to Topography of Involuntary Movements and Criterion of Their Abnormality
Waddington et al.
Arch Gen Psychiatry 1987;44:907-912.
ABSTRACT