Tardive Dyskinesia

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	Tardive Dyskinesia

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Contributing risk factors | Other conditions that may be present | Recommendations


	Tardive dyskinesia is a neurological syndrome caused by the long-term use of neuroleptic drugs. Neuroleptic drugs are generally prescribed for psychiatric disorders, as well as for some gastrointestinal and neurological disorders. Tardive dyskinesia is characterized by repetitive, involuntary, purposeless movements. Features of the disorder may include grimacing, tongue protrusion, lip smacking, puckering and pursing, and rapid eye blinking. Rapid movements of the arms, legs, and trunk may also occur. Impaired movements of the fingers may appear as though the patient is playing an invisible guitar or piano.

Risk factors for Tardive Dyskinesia:

Manganese Requirement

Administration of the trace mineral manganese (at 15mg per day) may prevent the development of tardive dyskinesia and higher amounts (up to 60mg per day) may reverse tardive dyskinesia that has already developed. [Manganese in dyskinesias. Am J Psychiatry 1976; 133: p.105, Am J Psychiatry 1997; 134: p.1448]

Tardive Dyskinesia suggests the following may be present:

Manganese Requirement

Administration of the trace mineral manganese (at 15mg per day) may prevent the development of tardive dyskinesia and higher amounts (up to 60mg per day) may reverse tardive dyskinesia that has already developed. [Manganese in dyskinesias. Am J Psychiatry 1976; 133: p.105, Am J Psychiatry 1997; 134: p.1448]

Recommendations for Tardive Dyskinesia:

Drug

GHB (Gamma-Hydroxybutyrate)

GHB has been reported to help control tardive dyskinesia symptoms.

A double-blind study demonstrated that 10mg of melatonin given at 8pm for 6 weeks is an effective treatment for tardive dyskinesia, although the magnitude of the effect was only modest. Other natural substances that have been reported to improve tardive dyskinesia include vitamin E, manganese and vitamin B6. It is possible that using these compounds in combination would be more effective than using any one individually. [Arch Gen Psychiatry 2001;58: pp.1049-52]

Lab Tests/Rule-Outs

Test Essential Fatty Acid Profile

See the link between Tardive Dyskinesia and Melatonin.

Essential Fatty Acids

In a pilot study of (n-3) fatty acid supplementation, the authors observed significant improvement in both schizophrenic symptoms and tardive dyskinesia over a 6 week period. [Prostaglandins Leukot Essent Fatty Acids. 1996 Aug;55(1-2): pp.71-5]

See the link between Tardive Dyskinesia and Melatonin.

Vitamin B6 (Pyridoxine)

See the link between Tardive Dyskinesia and Melatonin.

KEY

		Weak or unproven link
		Strong or generally accepted link
		May do some good
		Likely to help

GLOSSARY

Dyskinesia: A condition characterized by spasmodic, uncoordinated, or other abnormal movements; i.e., those which result from a reaction to phenothiazines.

Gastrointestinal: Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.

Manganese: An essential mineral found in trace amounts in tissues of the body. Adults normally contain an average of 10 to 20mg of manganese in their bodies, most of which is contained in bone, the liver and the kidneys. Manganese is essential to several critical enzymes necessary for energy production, bone and blood formation, nerve function and protein metabolism. It is involved in the metabolism of fats and glucose, the production of cholesterol and it allows the body to use thiamine and Vitamin E. It is also involved in the building and degrading of proteins and nucleic acid, biogenic amine metabolism, which involves the transmitting of nerve impulses.

Milligram: (mg): 1/1,000 of a gram by weight.

Mineral: Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.

Neuroleptic: A therapeutic agent which produces a state of altered awareness and tranquilization.