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Are Second-Generation Antipsychotics Useful in Tardive Dystonia?
Narsimha Reddy Pinninti1, Justin Faden, Adit Adityanjee
1*Department of Psychiatry, School of Osteopathic Medicine, Rowan University, Cherry Hill, NJ; and †North-Coast Behavioral Healthcare, Northfield, OH; ‡Department of Psychiatry, University of Minnesota Medical School, Duluth, MN; §St Mathews School of Medicine, Orlando, FL.
Clinical Neuropharmacology
|September 15, 2015
Summary
Second-generation antipsychotics (SGAs) show effectiveness in treating tardive dystonia (TDt). Clozapine is effective alone or with clonazepam, with olanzapine and quetiapine as alternatives.
Area of Science:
- Pharmacology
- Neurology
- Psychiatry
Background:
- Tardive dystonia (TDt) is a movement disorder often associated with antipsychotic use.
- Limited evidence exists on the efficacy of second-generation antipsychotics (SGAs) for TDt treatment.
Purpose of the Study:
- To review existing evidence on SGA effectiveness for tardive dystonia.
- To provide treatment recommendations for tardive dystonia.
Main Methods:
- Conducted comprehensive database searches (Medline, PubMed, Psyclit, Embase) in January 2015.
- Included English-language articles and abstracts reporting on TDt treatment.
- Performed a manual review of references from retrieved articles.
Main Results:
- Analyzed 88 reports involving 145 patients treated with SGAs; no controlled trials were identified.
- Clozapine was the most reported SGA, used in 52 reports with 90 subjects.
- Other SGAs (olanzapine, risperidone, quetiapine, aripiprazole, perospirone) were used in 36 reports with 55 subjects.
Conclusions:
- Clozapine demonstrates effectiveness as monotherapy and in combination with clonazepam for TDt.
- Olanzapine and quetiapine are viable alternatives when clozapine is not suitable.
- Highlights the need for rigorous, long-term, randomized, placebo-controlled clinical trials.
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