Estrogen receptor activation and tardive dyskinesia

To undertake a selective review of the epidemiology, etiology, and treatment of tardive dyskinesia (TD), with emphasis on the potential influence of estrogen in its expression.

Both Medline and Psycinfo databases were used to search for articles with the following key words: tardive dyskinesia, humans, animals, dopamine, estrogen, estrogen replacement therapy, antioxidants and oxidative stress.

The studies reviewed here suggest that estrogen modulates dopamine-mediated behaviours and that it protects against oxidative stress-induced cell damage caused by long-term exposure to antipsychotic medication.

Estrogen's multimodal role in the central nervous system may prove useful for the amelioration or prevention of TD. All the evidence suggests that a placebo-controlled, randomized trial with safer forms of estrogen should be conducted in postmenopausal women with TD.