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Date: Wed, 23 Aug 95 23:35:51 UT
From: "Gary Galambos" <Gary_Galambos@msn.com>
Subject: Treatment of tardive dyskinesia
From memory, a revision of the literature (scanty) indicated that the steps in treating TD were something like:
Date: Mon, 19 Feb 1996 02:16:33 -0500
Subject: Vitamin E for tardive dyskinesia
From: "Leslie E. Packer, PhD" <lpacker@pipeline.com>
Having done a database search, I find that the dose of vitamin E prescribed for TD has varied from about 600 mg/day up to about 1600-2000.
From: shakti@penn.com
Date: Mon, 19 Feb 1996 11:27:10 -0500
Subject: Vitamin E for tardive dyskinesia
Vitamin E seems to benefit patients in my experience in exactly the dosage range you mentioned, 400-2000 mg/day. One thing to remember is that vitamin E probably does its best work in very early TD and would not be very beneficial in TD present for a long time.
Date: Tue, 24 Dec 1996 07:24:35 -0500 (EST)
From: "Paul Luisada, M.D." <pvl2@cornell.edu>
Subject: Treatment of tardive dyskinesia
I've had surprisingly good results in two elderly patients with vitamin E (around 4000 IU/day) or E plus buspirone (15 to 30 mg per day) plus one to three months of time. Both had dyskinetic sx for at least 3 months without improvement before I started these meds, which leads me to believe that results were due to the intervention, rather than simply the passage of time.
Date: Sun, 29 Dec 1996 21:59:05 -0500
From: Hugues J Richard <kristof@cycor.ca>
Subject: Vitamins for tardive dyskinesia
I wrote, earlier:
One of my female patients with TD is on long acting fluphenazine. She is in her 30s. She responded well to vitamin E 800 IU tid + vitamin C 1 gr tid.Here are a few referrences:
3 double blind studies. Most patients on vitamin E 1600 IU had lower scores on the AIMS than patients on placebo. The response was better for TD that was of < 5 years duration and less severe.
Good article on free radical production due to the effects of neuroleptic on mitochondrial phosphorylation.
From: Cdbojrab@aol.com (Christopher D. Bojrab, M.D.)
Date: Wed, 19 Mar 1997 20:45:16 -0500 (EST)
Subject: Olanzapine and tardive dyskinesia
I have a patient with schizophrenia and major depression vs. schizoaffective disorder which were relatively refractory on numerous neuroleptics over 20 years. He started showing signs of TD, and I switched him to risperidone, with moderate improvement in TD but no improvement in psychotic symptoms. As an inpatient he was switched back to loxapine. His family stated his TD worsened. When I saw him back in clinic I added olanzapine at 10 mg qhs and after a few weeks tapered off the loxapine. His TD has dramatically improved (better than on risperidone) and his psychotic symptoms are better controlled than they have been in the 2 years I have known him and according to his family in many years.
Date: Sat, 30 Mar 1996 13:04:27 -0800 (PST)
From: Joseph Barrett <jbarrett@u.washington.edu>
Subject: Vitamin E for tardive dyskinesia
I have had several patients on Vitamin E with neuroleptics. It is my general impression that this supplement may be preventative of TD, but has little effect once the syndrome has begun.
Date: Wed, 09 Apr 1997 15:19:18 -0400
From: Eric Fier <efier+@pitt.edu>
Subject: Olanzapine and tardive dyskinesia
I have now seen several patients with recent onset of TD (1 year or less) respond beautifully to replacing their traditional/typical neuroleptic with olanzapine. I believe the olanzapine was at least as efficacious as an antipsychotic and clearly was better tolerated overall. I do not know if it exerts an "antidyskinetic" effect (like clozapine has been reputed to) or if cessation of the offending agent and replacement with a less TD-genic drug is the key to the success.
Date: Sun, 13 Apr 1997 21:34:13 -0700
From: "Kathleen Schilli, PharmD." <DrRx@ix.netcom.com>
Subject: Olanzapine and tardive dyskinesia
In the past I had a patient with T.D. who was placed on olanzapine (she had been on haloperidol) and high-dose vitamin E. She did much better, although we could not discontinue the haloperidol right away due to her psychotic symptoms. She ended up on olanzapine 15 mg with marked improvement.
Date: Fri, 25 Apr 1997 10:29:39 -0400
From: Jacqueline Aron <jaron@pipeline.com>
Subject: Tetrabenazine for tardive dyskinesia
At 09:41 AM 4/25/97 +0600, Darwin Buschman, MD wrote:
An elderly patient is suicidal secondary to shame over her tardive dyskinesia which does not improve even with increase in neuroleptic. I recall a similar case years ago where a patient recieved tetrabenazine (TBZ) from an experimental program and did well...TBZ is available curently via a research program in Texas, I believe the investagator is Jankovic [at Baylor]. It is an approved drug in both Canada and in the UK and can be gotten there with a legal rx. It is prescribed frequently at the movement disorders clinic in Winnipeg.
Please see: Jankovic J, Orman J. Tetrabenazine therapy of dystonia, chorea, tics, and other dyskinesias. Neurology. 38 (3): 391-4, 1988 Mar.
From: Hanson1072@aol.com (A. Hanson, M.D.)
Date: Mon, 5 May 1997 21:38:01 -0400 (EDT)
Subject: Diltiazem for tardive dyskinesia
I've read about diltiazem 30 mg qid as effective for T.D. -- I don't remember where.The article was a report of two severe cases of tardive dyskinesia treated with diltiazem:--Sander Fridman
Ross JL, Mackenzie TB, Hanson DR, Charles CR. Diltiazem for tardive dyskinesia. Lancet. 1 (8527): 268, 1987 Jan 31.
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Dr. Bob is Robert Hsiung, MD,
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