Therapy of extrapyramidal side effects, with particular reference to persistent dyskinesia and lithium tremor

In 13 of 27 cases of persistent dyskinesia, treatment with amantadine, in an average dose of 300 mg, brought good to moderate improvement. In 14 patients who showed no response whatever, further treatment, with bromocriptine in doses raised gradually to a final daily dosage of 15 mg, was effective in four cases, though the improvement was generally only moderate. In more than 50 percent of the cases of initial tremor induced by lithium therapy, oxprenolol in daily doses of 160--240 mg produced good effects and moderate improvement was noted in a few further cases. In a series of 20 patients with initial tremor due to neuroleptic therapy, on the other hand, the same treatment proved unsuccessful in the majority of cases. This is the converse of the experience gained with the classical antiparkinson agents, which have proved more effective against tremor induced by neuroleptics than against lithium-induced tremor.